Out of Hospital Cardiac Arrest
Conditions
Keywords
Out of Hospital Cardiac Arrest, Cardiopulmonary Resuscitation, dispatch, emergency medicine
Brief summary
The hypothesis of this study is Dispatcher-Activated Neighborhood Access Defibrillation and Cardiopulmonary Resuscitation (NAD-CPR) would improve survival of out-of-hospital cardiac arrest (OHCA).
Detailed description
Out-of-hospital cardiac arrest (OHCA) is a major health problem, occurring in about 1 in 1,500 adults in the developed countries each year. Although layperson CPR and defibrillation are crucial components of chain of survival, layperson CPR rate and it's quality is low and public-access defibrillation (PAD) program is not cost-effective.If trained bystanders can know the information of occurrence of OHCA and nearest place for automated external defibrillator (AED) at the same time by dispatch center, these neighborhoods could run and give high quality CPR and early defibrillation. If this protocol ,Dispatcher-Activated Neighborhood Access Defibrillation and Cardiopulmonary Resuscitation(NAD-CPR), is introduced to community, it may improve survival of OHCA.
Interventions
OTHERNAD-CPR
When Dispatcher detects OHCA, short message service (SMS)about the OHCA event and information about the location of nearest AED is sent to trained laypersons within geographically accessible area.
Sponsors
Korean Center for Disease Control and Prevention
Seoul Metropolitan Government Health and Welfare Office
Seoul Metropolitan Fire and Disaster Headquater
Korea Association for Safety Community
Seoul National University Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
15 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* all OHCA with presumed cardiac etiology more than 15 years old * assessed by emergency medical service (EMS) providers dispatched by dispatch center * dispatcher detected OHCA patients
Exclusion criteria
* OHCA with non-cardiac etiology * prolonged cardiac arrest with a suspected duration more than 30 minutes * cases with rigor mortis or rivor mortis, decapitated or decomposed body * Non detected cases by dispatcher
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants Surviving at Hospital Discharge | discharge time from first admission from emergency department within 2 month | we compared the survival to discharge rate between before intervention period and intervention period. Survival to discharge checked at the discharge point of hospital. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Pre-Hospital Return of Spontaneous Circulation (ROSC) | hospital arriving time from ambulance within 2 hours | we compared the Pre-hospital return of spontaneous circulation (ROSC) rate between before intervention period and intervention period. |
| Number of Participants With Good Neurological Recovery | discharge time from first admission from emergency department within 2 month | Cerebral performance category 1 or 2 is defined as good neurological recovery. we compared the good neurological recovery rate between before intervention period and intervention period. |
Countries
South Korea
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Conventional Dispatcher CPR patients enrolled in period that conventional dispatcher CPR was provided to the patients. | 1,498 |
| NAD-CPR patients enrolled in period that NAD-CPR was provided to the patients. | 1,696 |
| Total | 3,194 |
Baseline characteristics
| Characteristic | Conventional Dispatcher CPR | Total | NAD-CPR |
|---|---|---|---|
| Age, Continuous | 71 years | 72 years | 72 years |
| Race and Ethnicity Not Collected | — | 0 Participants | — |
| Region of Enrollment South Korea | 1498 Participants | 3194 Participants | 1696 Participants |
| Sex: Female, Male Female | 532 Participants | 1109 Participants | 577 Participants |
| Sex: Female, Male Male | 966 Participants | 2085 Participants | 1119 Participants |
| TM sent | 0 Participants | 598 Participants | 598 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 1,363 / 1,498 | 1,480 / 1,696 |
| other Total, other adverse events | 0 / 1,498 | 0 / 1,696 |
| serious Total, serious adverse events | 1,363 / 1,498 | 1,480 / 1,696 |
Outcome results
Primary
Number of Participants Surviving at Hospital Discharge
we compared the survival to discharge rate between before intervention period and intervention period. Survival to discharge checked at the discharge point of hospital.
Time frame: discharge time from first admission from emergency department within 2 month
Population: Study population excluding exclusion criteria
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Conventional Dispatcher CPR | Number of Participants Surviving at Hospital Discharge | 135 Participants |
| NAD-CPR | Number of Participants Surviving at Hospital Discharge | 216 Participants |
Secondary
Number of Participants With Good Neurological Recovery
Cerebral performance category 1 or 2 is defined as good neurological recovery. we compared the good neurological recovery rate between before intervention period and intervention period.
Time frame: discharge time from first admission from emergency department within 2 month
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Conventional Dispatcher CPR | Number of Participants With Good Neurological Recovery | 68 Participants |
| NAD-CPR | Number of Participants With Good Neurological Recovery | 140 Participants |
Secondary
Number of Participants With Pre-Hospital Return of Spontaneous Circulation (ROSC)
we compared the Pre-hospital return of spontaneous circulation (ROSC) rate between before intervention period and intervention period.
Time frame: hospital arriving time from ambulance within 2 hours
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Conventional Dispatcher CPR | Number of Participants With Pre-Hospital Return of Spontaneous Circulation (ROSC) | 107 Participants |
| NAD-CPR | Number of Participants With Pre-Hospital Return of Spontaneous Circulation (ROSC) | 223 Participants |