Effectiveness of a Communication Training Program in Improving the Handling of Calls for Suspected Cardiac Arrest at SAMU-Centre 15. (COM-ARM)

Effectiveness of a Communication Training Program in Improving the Handling of Calls for Suspected Cardiac Arrest at SAMU-Centre 15. A Multicenter, Randomized Controlled Stepped-Wedge Implementation Trial

Each year, France's emergency response services-the SAMU (15) and the fire department (18)-handle 31 million and 19 million calls, respectively. The effectiveness of this system depends on the call centers' ability to obtain location information, prioritize responses, assess the severity of each call, and dispatch appropriate emergency resources.

Cardiac arrest (CA) affects 40,000 people in France each year who call on this service. The survival rate decreases by 7 to 10% for every minute that elapses between cardiac arrest and the start of cardiopulmonary resuscitation (CPR). Early CPR performed by bystanders is associated with a survival rate 2-3 times higher than CPR initiated only after emergency responders arrive on the scene. CPR assisted by SAMU-Centre 15 dispatchers (T-CPR) is a way to provide CPR to patients before emergency responders arrive on the scene and is recommended as early as possible to improve survival. According to the American Heart Association (AHA) guidelines, the timing of the initiation of the chain of survival is considered high quality if T-CPR is initiated within 90 seconds.

Studies show that recognizing a cardiac arrest (CA) over the phone is often difficult for several reasons, including communication challenges, the caller's stress, and the presence of abnormal breathing.

Emergency medical dispatchers (EMDs) receive very little training on communication strategies, particularly those needed to optimally manage stressed and sometimes difficult callers. Interventions to improve communication have proven effective among healthcare professionals. These methods included face-to-face training, blended learning programs, simulation-based teamwork exercises, and communication techniques adapted from aviation. Standardized scripting systems have been shown to improve the speed of decision-making and the dispatch of emergency response teams. These scripts depend on the quality of the information provided by the caller and the caller's ability to communicate effectively with the EMD.

The objective of this study will be to evaluate the effect of a communication training program for Centre-15 emergency medical dispatchers on calls for cardiac arrest.

Study Overview

• Status: Not yet recruiting
• Conditions: Cardiac Arrest (CA)
• Intervention / Treatment: Other: Multifaceted intervention including 4 components

• Study Type: Interventional
• Enrollment (Estimated): 987
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Guillaume Debaty, MD, PhD; Phone Number: +334767634202; Email: gdebaty@chu-grenoble.fr
• Study Contact Backup: Name: Juliette Meyzenc; Phone Number: +33476634256; Email: jmeyzenc@chu-grenoble.fr

Study Locations

• France
  • Annecy, France
    • CH Annecy-Genevois
    • Contact: Thierry Roupioz
  • Bordeaux, France
    • CHU Bordeaux
    • Contact: Xavier Combes
  • Chambéry, France
    • CH Métropole Savoie- Chambéry
    • Contact: Heidi Mampe Armstrong
  • La Roche-sur-Yon, France
    • CH Vendée
    • Contact: Vincent Diot
  • Lyon, France
    • Hospices Civils de Lyon - HEH
    • Contact: Florent Femy
  • Nancy, France
    • Chru Nancy
    • Contact: Tahar Chouihed
  • Nantes, France
    • CHU Nantes
    • Contact: Simon Ribes
  • Rennes, France
    • CHU Rennes
    • Contact: Paul-Georges Reuter
  • Rouen, France
    • CHU Rouen
    • Contact: Mélanie Roussel
  • Toulouse, France
    • Chu Toulouse
    • Contact: Vincent Bounes

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Out-of-hospital cardiac arrest of presumed medical origin in an adult patient diagnosed during the phone call to the 15 emergency dispatch center

Non Inclusion Criteria:

• Minor patients,
• Calls initially handled by another emergency call center or a healthcare professional,
• Calls regarding cardiac arrest for which CPR has already been initiated at the time the call is made to the 15 center,
• Obvious or known pregnancy at the time of enrollment.
• Persons protected under Articles L1121-6 and L1121-8 of the Public Health Code (CSP).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Sequential Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; Standard patient care in accordance with international recommendations. Local protocols for handling
Experimental: Experimental; A multifaceted initiative combining training for SAMU Emergency medical dispatchers on the use of a standardized protocol, training on barriers to the early recognition of cardiac arrest, communication training to optimize interactions with callers, and training on handling difficult calls.	Other: Multifaceted intervention including 4 components; a multifaceted initiative combining training for SAMU-Centre 15 emergency medical dispatchers (EMDs) on the use of a standardized script, training on barriers to the early recognition of cardiac arrest, communication training to optimize the relationship with the caller, and training on handling difficult calls

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The effect of a multifaceted training intervention for SAMU-Centre 15 emergency medical technicians on the proportion of patients with out-of-hospital cardiac arrest of medical origin who receive early T-RCP within 90 seconds of the call being answered,	The p-roportion of out-of-hospital cardiac arrests of medical origin for which T-RCP guidance is initiated within 90 seconds of the EMD answering the call will be calculated by the time to initiation of T-CPR (defined as the time elapsed between the SAMU-Centre 15 operator answering the call and the first time the operator verbally provides cardiopulmonary resuscitation instructions to the caller) The criterion will be considered met when this time is 90 seconds or less.	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Survival with good neurological outcome at 30 days	Favorable neurological outcome at 30 days : Neurological outcome will be assessed by a physician using: - the Cerebral Performance Category (CPC) scale CPC 1 : Good Cerbral Performance -> CPC 5: Brain Death	30 days
Survival with good neurological outcome at 30 days	Favorable neurological outcome at 30 days : Neurological outcome will be assessed by a physician using: - the modified Rankin scale Scores: 0: No Symptoms -> 5: Severe disability	30 days
Return of Spontaneous Circulation (ROSC)	ROSC: defined by a clinical assessment of vital signs, including the presence of a palpable pulse or blood pressure	perioperatively/periprocedurally (during the CPR)
The proportion of patients admitted alive, discharged alive from the hospital, and alive at 30 days	Survival at hospital admission, discharge, and at 30 days	Day 0, day of discharge of the hospital and 30 days
The initial heart rate recorded	The initial heart rhythm recorded by a physician based on an analysis of the first heart rhythm recorded after the arrival of emergency medical personnel	Baseline
Proportion of recognized cardiac arrests	Percentage of calls for suspected cardiac arrest (CA) out of the total number of calls received for confirmed cardiac arrest (upon the arrival of emergency responders at the scene).	Baseline
Proportion of CAs recognized in calls for recognizable CAs	Percentage of calls for CAs identified relative to the number of calls received for identifiable CAs	Baseline
Proportion of CA calls receiving CPR guidance,	Percentage of calls receiving advice from T-RCP	Baseline
Proportion of CA calls in which the caller agrees to begin CPR for all CAs	Percentage of calls for CAs where the caller agrees to begin CPR for all CAs	Baseline
Time to recognize a cardiac arrest	Timeframe for the EMS to recognize the CA.	Baseline
Time to obtain location information	Time between answering the call and obtaining precise location information	Baseline
Percentage of cardiac arrests recognized within 60 seconds	Percentage of calls for CA recognized in less than 60 seconds, based on "recognizable" calls	Baseline
Percentage of cardiac arrests recognized within 90 seconds	Percentage of calls for CA recognized in less than 90 seconds, based on "recognizable" calls	Baseline
Time to begin CPR instructions	Timeframe for Initiating CPR instructions	Baseline
Percentage of calls where CPR instructions begin within 150 seconds	The proportion of out-of-hospital cardiac arrests of medical origin for which T-RCP guidance is initiated within 150 seconds of the EMD answering the call is defined by the time to initiation of T-CPR	Baseline
Quality of communication by the EMD	Call quality between the EMD and the caller: The evaluation will be conducted in accordance with the recommendations published by the Haute Autorité de Santé (HAS) [85], which include guidelines for conducting interviews with callers and communication protocols. An assessment of compliance with the decision-making algorithms will also be included. The evaluation will be carried out by experts during a blinded review of the trial period.	Immediately after the procedure
Impact on service quality	Impact analysis on Center 15 by evaluating the QS30	Day of inclusion

Collaborators and Investigators

• Sponsor: University Hospital, Grenoble
• Investigators: Study Director: Monique Sorrentino, Chu Grenoble Alpes

Study record dates

Study Major Dates

• Study Start (Estimated): October 1, 2026
• Primary Completion (Estimated): August 1, 2028
• Study Completion (Estimated): August 1, 2028

Study Registration Dates

• First Submitted: June 29, 2026
• First Submitted That Met QC Criteria: August 17, 2026
• First Posted (Actual): August 20, 2026

Study Record Updates

• Last Update Posted (Actual): August 20, 2026
• Last Update Submitted That Met QC Criteria: August 17, 2026
• Last Verified: August 1, 2026

More Information

Terms related to this study

• Keywords: Cardiac Arrest; Cardiopulmonary Resuscitation; Dispatcher
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Heart Diseases; Heart Arrest
• Other Study ID Numbers: 38RC22.0037

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Study protocol will be submitted for publication. IPD will be shared with other researcher.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No