Implementation of Gold Standard EMS CPR Programs for 2% Improvement in Survival Rates of Out-of-Hospital Cardiac Arrest in a Metropolitan City

Not Applicable

Terminated

• Conditions: Out-of-Hospital Cardiac Arrest
• Interventions: Procedure: Bundled EMS CPR approach including dispatcher-assisted CPR, 3-person team CPR, and feedback CPR monitoring device

• Registration Number: NCT02540629
• Lead Sponsor: Seoul National University Hospital

Brief Summary

This study aims to improve the survival rate of out-of-hospital cardiac arrest patients by 2% through a bundle of three intervention measures including: 1) dispatcher-assisted CPR, 2) multi-tiered response team CPR, and 3) feedback CPR.

Detailed Description

The project aims to implement gold standard emergency medical services (EMS) cardiopulmonary resuscitation (CPR) programs, which will result in increased bystander CPR, reduced EMS response time, and high quality CPR during prehospital resuscitation through a bundled approach including 1) dispatcher-assisted CPR (DA-CPR), 2) multi-tiered response team CPR, and 3) feedback CPR.

The DA-CPR program aims to contribute to improved bystander CPR rate and reduced EMS response time interval through rigorous monitoring of cardiac arrest detection at primary call receiving stage as well as increased number of dispatcher-assisted CPR instruction initiation in the target time of 90 seconds. The Team CPR protocol will render synergetic efforts among participating EMS personnel from both basic life support (BLS) and advanced life support (ALS) units within the new tiered dispatch system and subsequently deliver uninterrupted CPR to out-of-hospital cardiac arrest (OHCA) patients before hospital arrival. The feedback CPR monitoring and quality assurance program will contribute to high quality CPR delivered to the patients on the scene as well as during transport.

Study Timeline

• Study First Submitted: 2015-08-06
• Study First Submitted QC: 2015-09-01
• Study First Posted: 2015-09-04
• Study Start: 2016-01-01
• Primary Completion: 2018-12-31
• Study Completion: 2018-12-31
• Results First Submitted: 2019-04-17
• Status Verified: 2020-03
• Results First Submitted QC: 2020-03-16
• Last Update Submitted: 2020-03-16
• Results First Posted: 2020-03-30
• Last Update Posted: 2020-03-30

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 12670

Inclusion Criteria

• EMS-assessed OHCA
• Cardiac etiology
• Above 15 years of age

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Exclusion Criteria

• Patients who do not receive EMS resuscitation
• Patients with signs of evident death (decapitation, evident livor mortis or rigor mortis)
• Do-Not-Resuscitate cases
• Pregnant patients
• Patients whom the mechanical devices cannot be applied to

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
After intervention	Bundled EMS CPR approach including dispatcher-assisted CPR, 3-person team CPR, and feedback CPR monitoring device	The main study phase was planned to begin in January, 2016 through December, 2017, for a total of two years. Patients during the main study phase will have received one or more study interventions as applicable. However, because we could not continue our project in 2017, we changed after period. We included implementation period (2015) in after period. Therefore, final after period begins in January 2015 to December 2016.

Primary Outcome Measures

Name	Time	Method
Number of Participants With Survival to Hospital Discharge	At hospital discharge, up to 28 weeks from hospital admission	Number of EMS-assessed out-of-hospital cardiac arrest patients who survive to hospital discharge will be recorded.

Secondary Outcome Measures

Name	Time	Method
Number of Participants With Good Neurological Recovery at Discharge	At hospital discharge, up to 28 weeks from hospital admission	Number of EMS-assessed out-of-hospital cardiac arrest patients who survive to hospital discharge and has cerebral performance category 1 or 2 will be recorded.

Trial Locations

Locations (1)

Seoul National University Hospital; 🇰🇷 Seoul, Korea, Republic of