Dispatcher-Assisted CPR: Low-Dose, High-Frequency Simulation-Based Training

NCT04085692 | Completed DMC

• 1 other identifier: DTP
• Study Type: interventional
• Target: 52
• Locations: 1 country
• Sites: 1

Brief Summary

Clear, concise, yes, and no answers can be challenging to achieve in the assessment of consciousness and breathing in out-of-hospital cardiac arrest (OHCA) calls. Often callers will provide an unclear response, and this can lead to hesitation on the part of the Emergency Medical Dispatcher (EMD). Further, the relatively small proportion OHCA calls represent might demand the need for simulation training in the dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) guiding itself. Therefore, the investigators investigate whether low-dose, high-frequency (LDHF) simulation-based training of EMDs can increase the quality of DA-CPR in a simulation setting. Additionally, the investigators measure whether the effect of the training will be transferred to real OHCA calls. The study is a randomised controlled trial comparing LDHF simulation-based training to standard quality improvement of the EMD in a single centre. The study protocol is structured according to the SPIRIT 2013 statement, and the study will be reported in compliance with the CONSORT 2010 Statement. The investigators chose EMDs receiving standard quality improvement as the comparator group, to reflect a representative cohort of the EMDs not exposed to the LDHF simulation-based training program. The aims of this study are:

1. 1.To measure the effect of LDHF simulation-based training on the quality of DA-CPR in a simulation setting.
2. 2.To measure the effect of LDHF simulation-based training on the quality of DA-CPR in real OHCA calls.

Conditions

Out-Of-Hospital Cardiac Arrest

Outcome Measures

Primary Outcomes (1)

• Time from a call is taken by EMD to first bystander compression

  (seconds)

  During cardiac arrest calls, up to 1 hour

Secondary Outcomes (6)

• EMD clarifies status of consciousness and breathing before asking any additional questions

  During cardiac arrest calls, up to 1 hour

• Time from a call is taken by EMD to the recognition of cardiac arrest

  During cardiac arrest calls, up to 1 hour

• EMD starts DA-CPR instructions

  During cardiac arrest calls, up to 1 hour

• Time from a call is taken by EMD to EMD starts DA-CPR instructions

  During cardiac arrest calls, up to 1 hour

• EMD is assertive when starting CPR instructions

  During cardiac arrest calls, up to 1 hour

Study Arms (2)

Intervention

EXPERIMENTAL

The intervention group begins LDHF dispatcher training with one introduction week followed by twelve weeks of LDHF training. During the study period, all regular quality improvement (QI) activities, such as self-audits, case reviews, mentor groups, and status meetings will continue for all EMDs.

Behavioral: Low-Dose, High-Frequency Simulation-Based Training

Comparison

NO INTERVENTION

During the study period, all regular quality improvement (QI) activities, such as self-audits, case reviews, mentor groups, and status meetings will continue for all EMDs.

Interventions

Low-Dose, High-Frequency Simulation-Based Training BEHAVIORAL

Twelve weeks of LDHF training The simulation-based training sessions take place at the EMDC, at extra workstations set-up as ordinary EMD workstations in an out-of-the-way area. Before each session, the EMD is informed about the simulation call and receives instructions concerning technical differences from a regular call. The instructor acts as a "standardised caller", guided by a computer program. This program, the Danish version of Resuscitation Quality Improvement for Telecommunicators (Laerdal Medical AS, Stavanger, Norway), is a training program for DA-CPR based on the simulation platform Laerdal Learning Application. This modified version of the RQI-T program has, one test scenario, one data collection scenario and six different cardiac arrests scenarios as well as a feedback checklist based on the Danish dispatcher protocol Danish Index for Emergency Care. Each simulation session takes approximately 20 minutes, including introduction and feedback

Intervention

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• \- EMD employed at the Copenhagen EMS at the time of enrolment.

You may not qualify if:

• Mean working time as call taker at Copenhagen EMS \< 8 hours/week.
• Planned employment cessation at the Copenhagen EMS during the data collection period.
• Planned leave from work longer than four weeks during the data collection period.
• Starting employment at the Copenhagen EMS during the study period.

Sponsors & Collaborators

• Emergency Medical Services, Capital Region, Denmark: lead
• TrygFonden, Denmark: collaborator

Study Sites (1)

Copenhagen Emergency Medical Services

Copenhagen, Denmark

Location

MeSH Terms

Conditions

Out-of-Hospital Cardiac Arrest

Condition Hierarchy (Ancestors)

Heart Arrest; Heart Diseases; Cardiovascular Diseases

Study Officials

• Freddy Lippert, MD

  Emergency Medical Services, Capital Region, Denmark

  PRINCIPAL INVESTIGATOR

• Oscar Rosenkrantz

  Emergency Medical Services, Capital Region, Denmark

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The research group and the participants will not be blinded to the allocation, except for the study statistician (A.K.E.), who will conduct all analyses blinded to the intervention group. Thus, the study statistician will not have access to the randomisation scheme or the random seed and will receive a dataset with the actual groups replaced with the numbers 0 and 1
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Model Details: After enrolment and consent from the EMDs, the EMDs will be randomly assigned to receive either LDHF simulation-based dispatcher training (intervention arm) or no LDHF simulation-based dispatcher training (comparison arm). The EMDs will be randomly assigned to intervention or comparison group in a 1:1 ratio. Randomisation will be stratified by the EMDs' medical backgrounds (paramedic, approximately 30% of the EMDs, or registered nurse, approximately 70% of the EMDs), to balance the number of EMDs with different medical backgrounds randomly assigned to each arm.

Study Record Dates

• First Submitted: September 2, 2019
• First Posted: September 11, 2019
• Study Start: September 12, 2019
• Primary Completion: December 25, 2019
• Study Completion: December 25, 2019
• Last Updated: January 23, 2020

Record last verified: 2020-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: Immediately following publication. Until 31st of December 2021
• Access Criteria: Researchers who provide a sound proposal and gets approval from the Danish authorities.

Locations

DK (1)