Survival Study After Out-of-hospital Cardiac Arrest (SAMS)

Dual Dispatch of EMS, Fire Fighters and/or Police in Out-of-hospital Cardiac Arrest Implemented in Nine Counties in Sweden - Can More Lives be Saved by Using This Method?

The purpose of this study is to determine if dual dispatch of ambulance, fire fighters and/or police in out-of-hospital cardiac arrest (OHCA), can reduce the time to cardiopulmonary resuscitation (CPR) and defibrillation, thus increasing survival.

Study Overview

• Status: Unknown
• Conditions: Out-of-Hospital Cardiac Arrest
• Intervention / Treatment: Other: Simultaneously dispatch of firefighters and/or police in case of OHCA

Detailed Description

Hypothesis If simultaneous dispatch of ambulance (EMS), firefighters and/or police is being initiated when an OHCA occurs, then the two latter units will be first at scene, before the ambulance crew, in ≥30% of the cases. We anticipate therefore that overall 30-days survival will increase on a national level from 9% to 12%.

Method During the period 110901 to 141231 all OHCA cases will be analyzed were the emergency medical communication centre (EMCC) has dispatched ambulance, firefighters and/or the police. Participating in the Saving More Lives in Sweden (SAMS) project are the following counties: Stockholm, Sodermanland, Jonkoping, Vastra Gotaland (VG Region), Halland, Dalarna, Jamtland, Kalmar and Uppsala. Data is collected by the units being dispatched and thereafter sent on line to a database managed by Registercentrum in Gothenburg (http://www.registercentrum.se/), administrators of the Swedish Cardiac Arrest Register.

Parameters obtained are:

• Time for dispatch of fire fighters and/or police (recorded digitally).
• Time for arrival to the patient.
• Verification if cardiac arrest or not.
• CPR performed by fire fighters or police before arrival of EMS.
• Automated External Defibrillator (AED) connected to the patient.
• If yes, was the first recorded rhythm shockable, i.e. ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT).
• Time to defibrillation.

Survival data during from the Swedish Cardiac Arrest Register (SCAR) will be obtained during the same time period from nine comparable Swedish regions not participating in the SAMS study.

• Study Type: Interventional
• Enrollment (Anticipated): 6000
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Leif Svensson; Phone Number: +4686161000; Email: leif.svensson@ki.se
• Study Contact Backup: Name: Johan Herlitz; Phone Number: +46334354000; Email: johan.herlitz@gu.se

Study Locations

• Sweden
  • Stockholm, Sweden, SE-11883
    • Recruiting
    • Center for Resuscitation Science, Sodersjukhuset
    • Contact: Leif Svensson, MD, PhD; Phone Number: +4686161000; Email: leif.svensson@ki.se
    • Contact: Johan Herlitz, MD, PhD; Phone Number: +46334354000; Email: johan.herlitz@gu.se

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 8 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• All cases where the dispatcher suspects cardiac arrest, i.e. unconscious person with abnormal or no breathing

Exclusion Criteria:

• Children < 8 y
• Obviously deceased persons according to regulations in EMS protocols

Study Plan

How is the study designed?

Design Details

• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Dual dispatch; Simultaneously dispatching of EMS, firefighters and/or police in OHCA	Other: Simultaneously dispatch of firefighters and/or police in case of OHCA; In case of OHCA, firefighters and/or police trained in CPR and equipped with AEDs will be dispatched in parallel with EMS in nine counties in Sweden.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Survival	30-days after out-of-hospital cardiac arrest (OHCA)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time for dispatching of fire fighters and/or police	Data are obtained digitally from the dispatch center.	Up to 1 y after ending recruitement
Time for arrival to the patient	Data are collected both digitally from the dispatch center and from protocols sent in on line by first responders.	Up to 1 y after ending recruitement
Time for attaching the defibrillator to the patient	Data are collected from protocols sent in on line by first responders.	Up to 1 y after ending recruitement
Time to first defibrillation	Data collected from the protocol sent in on line by first responders.	Up to 1 y after ending recruitement

Collaborators and Investigators

• Sponsor: Karolinska Institutet
• Collaborators: Swedish Heart Lung Foundation; Ministry of Health and Social Affairs, Sweden; Swedish Association of Local Authorities and Regions; The Laerdal Foundation for Acute Medicine in Norway
• Investigators: Principal Investigator: Leif Svensson, MD, PhD, Center for Resuscitation Science, Karolinska Institutet, Stockholm, Sweden

Publications and helpful links

General Publications

• Hasselqvist-Ax I, Nordberg P, Herlitz J, Svensson L, Jonsson M, Lindqvist J, Ringh M, Claesson A, Bjorklund J, Andersson JO, Ericson C, Lindblad P, Engerstrom L, Rosenqvist M, Hollenberg J. Dispatch of Firefighters and Police Officers in Out-of-Hospital Cardiac Arrest: A Nationwide Prospective Cohort Trial Using Propensity Score Analysis. J Am Heart Assoc. 2017 Oct 4;6(10):e005873. doi: 10.1161/JAHA.117.005873.

Study record dates

Study Major Dates

• Study Start: September 1, 2011
• Primary Completion (Anticipated): December 1, 2014
• Study Completion (Anticipated): December 1, 2014

Study Registration Dates

• First Submitted: June 27, 2014
• First Submitted That Met QC Criteria: July 8, 2014
• First Posted (Estimate): July 9, 2014

Study Record Updates

• Last Update Posted (Estimate): July 9, 2014
• Last Update Submitted That Met QC Criteria: July 8, 2014
• Last Verified: July 1, 2014

More Information

Terms related to this study

• Keywords: Survival; Police; Cardiac Arrest; Firefighters; Out-of-Hospital Cardiac Arrest; Defibrillators
• Additional Relevant MeSH Terms: Heart Diseases; Cardiovascular Diseases; Heart Arrest; Out-of-Hospital Cardiac Arrest
• Other Study ID Numbers: SAMS 242-11