MedPath

The HeartRunner Trial

Not Applicable
Recruiting
Conditions
Out-Of-Hospital Cardiac Arrest
Interventions
Other: Activation of HeartRunners
Registration Number
NCT03835403
Lead Sponsor
Emergency Medical Services, Capital Region, Denmark
Brief Summary

The study will assess 30-day survival for cases where volunteer citizen responders ('heart runners') were activated through a smartphone app to retrieve an AED in case of suspected out-of-hospital cardiac arrest (OHCA) versus standard emergency medical services care. The study will randomize emergency medical dispatch center incoming calls which are suspected out-of-hospital cardiac arrest, such that half will be randomized to activation of heart runners and half to no activation of heart runners (standard care). The study will also assess physical or psychological risks involved for the activated heart runners.

Detailed Description

Chances of survival after out-of-hospital cardiac arrest decrease 10% per minute from collapse until defibrillation. Activating volunteer citizens through the emergency medical dispatch center can potentially increase rates of bystander defibrillation and survival. The HeartRunner trial will investigage the effect of activating registered volunteer citizens through a mobile app integrated with the emergency medical services on 30-day survival following out-of-hospital cardiac arrest. Both arms will receive standard care by the Emergency Medical Services. The intervention arm will additionally receive the activation of volunteer citizen responders. The randomization will take place independently in 3 different strata according to heart runner distance to OHCA (\< 3 min, 3-9 min, \> 9 min). The trial will also assess whether it is safe, both physically and psychologically, to activate volunteer citizen responders to respond to out-of-hospital cardiac arrests.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
1600
Inclusion Criteria
  • All out-of-hospital cardiac arrests recognized by Emergency Medical Dispatcher and where the HeartRunner system is activated.
  • Non-traumatic etiology, this excludes intoxication, drowning or suicide.
  • Age > 7 years
Exclusion Criteria
  • Caller is not in direct contact with the patient
  • If Emergency Medical Dispatcher deems AED is not indicated, e.g., in nursing homes where trained personal is present.
  • OHCAs not treated by the EMS due to ethical reasons or obvious signs of death
  • OHCAs with no heart runners within 1800 meters
  • Not true cardiac arrest (suspected, but not verified)
  • EMS-witnessed OHCAs

Emergency medical dispatchers are instructed not to activate heart runners in case any of the exclusion criteria above. However, since it can be challenging for emergency medical dispatchers to gather sufficient information about the patient within the first few minutes, heart runners will admittedly be activated even though they should not have been. Since randomization will occur for all cases in which a heart runner is activated, cases with any of the exclusion criteria will be secondarily excluded.

These cases will be accounted for but not included in analyses of outcome. Our pilot study showed approximately 60% of suspected cardiac arrests were true cardiac arrests. Therefore, we expect 40% of cases for which heart runners were dispatched not to be true cardiac arrests.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
HeartRunner ActivationActivation of HeartRunnersFor these cardiac arrests, HeartRunners will be activated in addition to standard EMS response.
Primary Outcome Measures
NameTimeMethod
30-day survival30 days after date of out-of-hospital cardiac arrest

Patient alive 30 days after date of out-of-hospital cardiac arrest

Secondary Outcome Measures
NameTimeMethod
Rates of bystander cardiopulmonary resuscitationDuring cardiac arrest

Percentage of patients who received bystander cardiopulmonary resuscitation prior to EMS arrival

Rates of return of spontaneuous circulationImmediately after out-of-hospital cardiac arrest

sustained circulation indicating successful resuscitation

Rates of survival after 1 year1 year after date of out-of-hospital cardiac arrest

percentage of patients alive 1 year after out-of-hospital cardiac arrest

Rates of neurological intact survivalAt hospital discharge

percentage of patients with cerebral performance category score of 1-2

Rates of bystander defibrillationDuring cardiac arrest

Percentage of patients who received defibrillation prior to EMS arrival

Trial Locations

Locations (1)

Emergency Medical Services Copenhagen

🇩🇰

Copenhagen, Ballerup, Denmark

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