An Educational Program to Improve Cardiac Arrest Diagnostic Accuracy of Ambulance Telecommunicators

NCT03894059 | Active Not Recruiting

• 1 other identifier: CRRF 1298
• Study Type: observational
• Target: 12,224
• Locations: 1 country
• Sites: 1

Brief Summary

Cardiac arrest is the number one cause of death in Canada. It is often the first symptom of cardiac disease for the victims. Eighty-five percent of victims collapse in their own home. Fifty percent collapse in the presence of a family member. Bystander cardiopulmonary resuscitation (CPR) can improve the chance to survive a cardiac arrest by three to four times, but needs to be started quickly. In most communities, less than 30% of victims receive CPR before the ambulance arrives. Currently, only 8% of cardiac arrest victims can leave the hospital alive. Many things have been tried to improve the number of times people do CPR. So far, the only thing that really increased the number of times that someone did CPR is when 9-1-1 attendants started to give CPR instructions to callers over the phone. The only problem is that about 25% of cardiac arrest victims gasp for air in the first few minutes. This can fool the 9-1-1 callers and attendants into thinking that the victim is still alive. The investigators have looked at all the studies on how to help 9-1-1 attendants to recognize abnormal breathing over the phone. The investigators have also learned what should be taught after finishing a large survey with 9-1-1 attendants from across Canada. This survey was done with the help of psychologists and other education experts. It measured the impact of attitudes, social pressures, and 9-1-1 attendants' perceived control over their ability to recognize abnormal breathing and cardiac arrest. Then the investigators developed a teaching tool which helped Ottawa 9-1-1 attendants recognize abnormal breathing. When they could do that, they could also recognize more cardiac arrest. The main goal of this project is to use the tool developed in Ottawa in more centres to help 9-1-1 attendants save the lives of even more cardiac arrest victims across Canada.

Conditions

Heart Arrest; Heart Arrest, Out-Of-Hospital; Cardiac Arrest; Death, Sudden, Cardiac; Cardiac Arrest, Sudden; Cardiopulmonary Arrest

Keywords

cardiac arrest; bystander cardiopulmonary resuscitation CPR; dispatch-assisted CPR instructions; agonal breathing

Outcome Measures

Primary Outcomes (1)

• Overall Survival

  Accessing hospital medical records or coroner's reports, assess survival of cardiac arrest victim as being discharged alive from hospital.

  Change between 12 month period before and after delivery of additional education to ambulance telecommunicators

Secondary Outcomes (5)

• Community Bystander Cardiopulmonary Resuscitation Rate

  Change between 12 month period before and after delivery of additional education to ambulance telecommunicators

• Telecommunication-assisted CPR instructions rate

  Change between 12 month period before and after delivery of additional education to ambulance telecommunicators

• Presence of agonal breathing

  Change between 12 month period before and after delivery of additional education to ambulance telecommunicators

• Cardiac arrest recognition rate

  at time of event

• Time intervals

  Change between 12 month period before and after delivery of additional education to ambulance telecommunicators

Study Arms (2)

Retrospective

Consecutive cases of out-of-hospital cardiac arrest occurring at participating sites, meeting the study eligibility criteria over a 12-month period preceding the implementation of the educational intervention for ambulance telecommunicators.

Prospective

Consecutive cases of out-of-hospital cardiac arrest occurring at participating sites, meeting the study eligibility criteria over a 12-month period following the implementation of the educational intervention for ambulance telecommunicators.

Other: Educational Intervention

Interventions

Educational Intervention OTHER

Additional training provided to ambulance telecommunicators in participating sites to help increase recognition of agonal breathing in the presence of out-of-hospital cardiac arrest.

Prospective

Eligibility Criteria

• Age: 16 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients with prehospital cardiac arrest (absence of a detectable pulse, unresponsiveness, and apnea) occurring in the catchment area of any participating site during the active study period.

You may qualify if:

• We will enroll ALL patients with prehospital cardiac arrest (absence of a detectable pulse, unresponsiveness, and apnea):
• That are of presumed cardiac origin;
• That occur in the catchment area of our participating sites; and
• For which resuscitation is attempted by a bystander and/or the emergency responders.

You may not qualify if:

• Cardiac arrest witnessed by paramedics after their arrival (no opportunity for bystander intervention);
• Patients younger than 16 years of age (cardiac arrest usually respiratory and rare in this population);
• Patients who are "obviously dead";
• Trauma victims, including hanging and burns; or
• Patients with cardiac arrest clearly of other non-cardiac origin including drug overdose, carbon monoxide poisoning, drowning, exsanguination, electrocution, asphyxia, hypoxia related to respiratory disease, cerebrovascular accident and documented terminal illness.

Sponsors & Collaborators

• Ottawa Hospital Research Institute: lead
• Ontario Ministry of Health and Long Term Care: collaborator
• BC Emergency Health Services: collaborator
• Medacom Atlantic: collaborator
• Alberta Health services: collaborator
• Emergency Health Services Nova Scotia: collaborator
• Health PEI: collaborator
• Providence Health Care, British Columbia: collaborator

Study Sites (1)

Emergency Medical Care Inc.

Dartmouth, Nova Scotia, B3B 2B2, Canada

Location

Related Publications (1)

• Vaillancourt C, Charette M, Naidoo S, Taljaard M, Church M, Hodges S, Leduc S, Christenson J, Cheskes S, Dainty K, Feldman M, Goldstein J, Tallon J, Helmer J, Sibley A, Spidel M, Blanchard I, Garland J, Cyr K, Brehaut J, Dorian P, Lacroix C, Zambon S, Thiruganasambandamoorthy V. Multi-centre implementation of an Educational program to improve the Cardiac Arrest diagnostic accuracy of ambulance Telecommunicators and survival outcomes for sudden cardiac arrest victims: the EduCATe study design and methodology. BMC Emerg Med. 2021 Mar 4;21(1):26. doi: 10.1186/s12873-021-00416-4.

  PMID: 33663395 DERIVED

MeSH Terms

Conditions

Heart Arrest; Out-of-Hospital Cardiac Arrest; Death, Sudden, Cardiac

Interventions

Early Intervention, Educational

Condition Hierarchy (Ancestors)

Heart Diseases; Cardiovascular Diseases; Death, Sudden; Death; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Child Health Services; Community Health Services; Health Services; Health Care Facilities Workforce and Services; Preventive Health Services

Study Officials

• Christian Vaillancourt, MD, MSc

  Ottawa Hospital Research Institute

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 19, 2019
• First Posted: March 28, 2019
• Study Start: December 14, 2020
• Primary Completion: December 31, 2025
• Study Completion: December 31, 2025
• Last Updated: October 29, 2024

Record last verified: 2024-10

Locations

CA (1)