Effects of a New Dispatcher-Assisted Basic Life Support Training Program (HEROS)

Clinical Effects of a New Dispatcher-Assisted Basic Life Support Training Program in a Metropolitan City: A Before-and-After Intervention Study

Despite aggressive cardiopulmonary resuscitation (CPR) training, the outcome of cardiac arrest is not good. The problem is method of education. So, the investigators want to add the dispatcher-assisted CPR simulation into conventional CPR training. In this study, the study is aimed to investigate the effect of newer CPR training program.

Study Overview

• Status: Completed
• Conditions: Out of Hospital Cardiac Arrest
• Intervention / Treatment: Other: BLS CPR program with dispatcher assisted CPR simulation

Detailed Description

The training program focuses on working in team with dispatcher, performing all steps from recognizing cardiac arrest to performing CPR, together with the dispatcher. The one hours training session is split into four parts:

1. Video self-instruction manikin practice (30 min), including a brief introduction to automated external defibrillator (AED).
2. Practice in pairs (15 min). Practicing the dispatcher and rescuer role in a simulation to enhance learning.
3. Debriefing. Questions, answers and reflection (15 min).
4. Homework. Leaflet with tasks like learn how to activate the speaker function on your own phone.

The main difference between dispatcher-assisted basic life support (DA-BLS) and traditional BLS training is that DA-BLS provides the scenes and interactive experiences on calling emergency medical service (EMS) and receiving CPR instruction via telephone speaker function, following up the skill training by scenario simulation training.

• Study Type: Interventional
• Enrollment (Actual): 18822
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Korea, Republic of
  • Seoul, Korea, Republic of, 110-744
    • Seoul National University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 19 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• All out-of-hospital cardiac arrest (OHCA) patients with presumed cardiac etiology who are 19 years of age or older and assessed and treated by EMS providers after dispatched by the EMS dispatch center will be included.

Exclusion Criteria:

• We will exclude patients with non-cardiac etiology, prolonged cardiac arrest with a suspected duration more than 30 minutes, cases such as livor mortis or rigor mortis, and decapitated or decomposed body, and patients who have "Do-Not-Resuscitate" card documented by doctor.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: New DA-BLS training program; A one-hour training course that includes a 30-minute video-based self-instruction (VSI) training session, a short role-play, and a debriefing. The video consists of a bystander CPR simulation with dispatcher instructions using the trainee's own phone and practice session following demonstration by a simulated layperson. After watching the video clip, all trainees are divided into two groups and conduct a role-play as dispatchers and laypersons for 15 minutes. Finally, there is a 15-minute debriefing session with several assignments. The HEROS program focuses on cooperation with a dispatcher, from recognition of cardiac arrest to performing DA-CPR, with hands-on practice so that laypersons can provide bystander CPR immediately in a real situation. Moreover, the HEROS program emphasizes practice for providing the correct address of the scene and switching to speakerphone mode, especially for the elderly.	Other: BLS CPR program with dispatcher assisted CPR simulation; the training program more focuses on cooperation with a dispatcher, from recognition to perform DA-CPR and hands-on practice.
No Intervention: Current Basic Life Support (BLS) training program; A one-hour training program that was developed by the Korea Center for Disease Control and Prevention (CDC) and it was based on the American Heart Association (AHA) guideline (http://www.cdc.go.kr/board.es?mid=a20503050000&bid=0021&tag=&act=view&list_no=127655). The program consists of a 30-minute VSI, and a 30-minute practice debriefing session. It focuses on detailed techniques for performing high-quality chest compressions including the correct hands and body position of the bystanders.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants Surviving to Hospital Discharge	The study end points are survival to hospital discharge. Survival to discharge will be measured as proportions of patients who were discharged from a hospital with their spontaneous circulation recovered. This information will be collected from medical record review.	from date of discharge, assessed up to 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants With Return of Spontaneous Circulation (ROSC)	The return of spontaneous circulation will be measured as proportion of the patients who were recovered their circulation at emergency department. This information will be collected from the medical review.	from date of cardiac arrest occurred, assessed up to 1 week
Number of Participants With Good Neurological Recovery	The Cerebral Performance Categories (CPC) score will be used to measure neurological recovery status: CPC 1 (good cerebral performance), CPC 2 (moderate cerebral disability), CPC 3 (severe cerebral disability), CPC 4 (coma or vegetative state), CPC 5 (brain death). We defined the good neurological recovery as CPC 1 or CPC 2. This information will be collected from medical record review.	from date of discharge, assessed up to 3 months

Collaborators and Investigators

• Sponsor: Seoul National University Hospital
• Investigators: Study Chair: Sang Do Shin, MD, MPH, PHD, Seoul National University Hospital

Publications and helpful links

General Publications

• Park GJ, Song KJ, Shin SD, Hong KJ, Kim TH, Park YM, Kong J. Clinical effects of a new dispatcher-assisted basic life support training program in a metropolitan city. Medicine (Baltimore). 2022 Jul 15;101(28):e29298. doi: 10.1097/MD.0000000000029298.

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2014
• Primary Completion (Actual): December 1, 2017
• Study Completion (Actual): December 1, 2018

Study Registration Dates

• First Submitted: May 13, 2014
• First Submitted That Met QC Criteria: May 16, 2014
• First Posted (Estimate): May 20, 2014

Study Record Updates

• Last Update Posted (Actual): May 1, 2020
• Last Update Submitted That Met QC Criteria: April 29, 2020
• Last Verified: April 1, 2020

More Information

Terms related to this study

• Keywords: survival; cardiac arrest; dispatcher-assisted bystander cardiopulmonary resuscitation
• Additional Relevant MeSH Terms: Heart Diseases; Cardiovascular Diseases; Heart Arrest; Out-of-Hospital Cardiac Arrest
• Other Study ID Numbers: SNUH-heros-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO