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.
調査の概要
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前：Guillaume Debaty, MD, PhD
- 電話番号：+334767634202
- メール：gdebaty@chu-grenoble.fr
研究連絡先のバックアップ
- 名前：Juliette Meyzenc
- 電話番号：+33476634256
- メール：jmeyzenc@chu-grenoble.fr
研究場所
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Annecy、フランス
- Ch Annecy-Genevois
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コンタクト：
- Thierry Roupioz
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Bordeaux、フランス
- CHU Bordeaux
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コンタクト：
- Xavier Combes
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Chambéry、フランス
- CH Métropole Savoie- Chambéry
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コンタクト：
- Heidi Mampe Armstrong
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La Roche-sur-Yon、フランス
- CH Vendée
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コンタクト：
- Vincent Diot
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Lyon、フランス
- Hospices Civils de Lyon - HEH
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コンタクト：
- Florent Femy
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Nancy、フランス
- CHRU NANCY
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コンタクト：
- Tahar Chouihed
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Nantes、フランス
- CHU Nantes
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コンタクト：
- Simon Ribes
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Rennes、フランス
- Chu Rennes
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コンタクト：
- Paul-Georges Reuter
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Rouen、フランス
- CHU Rouen
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コンタクト：
- Mélanie Roussel
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Toulouse、フランス
- CHU Toulouse
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コンタクト：
- Vincent Bounes
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
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).
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：順次割り当て
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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介入なし：Control
Standard patient care in accordance with international recommendations.
Local protocols for handling
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|
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実験的：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.
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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
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
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,
時間枠：Baseline
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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
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Survival with good neurological outcome at 30 days
時間枠：30 days
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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
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Survival with good neurological outcome at 30 days
時間枠：30 days
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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
|
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Return of Spontaneous Circulation (ROSC)
時間枠：perioperatively/periprocedurally (during the CPR)
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ROSC: defined by a clinical assessment of vital signs, including the presence of a palpable pulse or blood pressure
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perioperatively/periprocedurally (during the CPR)
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The proportion of patients admitted alive, discharged alive from the hospital, and alive at 30 days
時間枠：Day 0, day of discharge of the hospital and 30 days
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Survival at hospital admission, discharge, and at 30 days
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Day 0, day of discharge of the hospital and 30 days
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The initial heart rate recorded
時間枠：Baseline
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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
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Baseline
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Proportion of recognized cardiac arrests
時間枠：Baseline
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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
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Proportion of CAs recognized in calls for recognizable CAs
時間枠：Baseline
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Percentage of calls for CAs identified relative to the number of calls received for identifiable CAs
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Baseline
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Proportion of CA calls receiving CPR guidance,
時間枠：Baseline
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Percentage of calls receiving advice from T-RCP
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Baseline
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Proportion of CA calls in which the caller agrees to begin CPR for all CAs
時間枠：Baseline
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Percentage of calls for CAs where the caller agrees to begin CPR for all CAs
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Baseline
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Time to recognize a cardiac arrest
時間枠：Baseline
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Timeframe for the EMS to recognize the CA.
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Baseline
|
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Time to obtain location information
時間枠：Baseline
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Time between answering the call and obtaining precise location information
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Baseline
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Percentage of cardiac arrests recognized within 60 seconds
時間枠：Baseline
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Percentage of calls for CA recognized in less than 60 seconds, based on "recognizable" calls
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Baseline
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Percentage of cardiac arrests recognized within 90 seconds
時間枠：Baseline
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Percentage of calls for CA recognized in less than 90 seconds, based on "recognizable" calls
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Baseline
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Time to begin CPR instructions
時間枠：Baseline
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Timeframe for Initiating CPR instructions
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Baseline
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Percentage of calls where CPR instructions begin within 150 seconds
時間枠：Baseline
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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
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Baseline
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Quality of communication by the EMD
時間枠：Immediately after the procedure
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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.
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Immediately after the procedure
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Impact on service quality
時間枠：Day of inclusion
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Impact analysis on Center 15 by evaluating the QS30
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Day of inclusion
|
協力者と研究者
捜査官
- スタディディレクター：Monique Sorrentino、CHU Grenoble Alpes
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
- ICF
- CSR
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米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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