Out-Of-Hospital Cardiac Arrest
Conditions
Keywords
OHCA, Feedback, CPR quality
Brief summary
The purpose of this study is to investigate the quality of cardio-pulmonary resuscitation(CPR) delivered by EMS professionals and whether this quality can be improved by implementing real-time feedback during the event and an oral post-event debriefing procedure based on the actual event performance data.
Detailed description
The aim of this study is to investigate whether CPR quality can be improved by implementing real-time feedback and immediate oral structured post-event debriefing in out-of-hospital cardiac arrest (OHCA). The objectives of this study is to assess the current quality of CPR delivered by emergency medical services (EMS) during OHCA events in the Capital Region of Denmark. Furthermore, to investigate if CPR quality can be improved by applying real-time feedback during OHCA resuscitation attempts and to investigate if structured oral post-event debriefing delivered immediately after a resuscitation attempt and based on data from the defibrillator can further improve CPR quality The hypothesis of this study is that adding real-time and post event feedback can improve the compression rate, compression depth, overall CPR hands-on time (CPR fraction), and recoil with at least 15% in total for both interventions. Using a prospective study design data is retrieved from the standard defibrillator (ZOLL X series) through ZOLL RescueNet® Case Review (software for post-event review, analysis, and debriefing) from ZOLL Medical Corporation, Massachusetts, United States of America. The study consists of three consecutive phases. Phase one with no feedback / debriefing available for EMS. Phase two with real-time feedback during the event and phase three which adds post-event debriefing to real-time feedback. We expect to be able to include at least 500 cases in each phase.
Interventions
OTHERReal time feedback
Real-time feedback on chest compression depth, chest compression rate and recoil available to EMS while performing CPR. Feedback is delivered as visual text, numeric and graphical presentations on the defibrillator with audio tones for rate.
BEHAVIORALPost-event debriefing
Structured oral post-event debriefing based on objective performance data from the resuscitation attempt. The debriefing is conducted as hot/immediate self-directed debriefing session with a maximum length of 10 minutes.
Sponsors
TrygFonden, Denmark
St George's, University of London
Kingston University
Emergency Medical Services, Capital Region, Denmark
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 110 Years
Healthy volunteers
Yes
Inclusion criteria
OHCA
Exclusion criteria
No use of EMS defibrillator attached to patient during resuscitation attempt Patients \< 18 years of age OHCA without involvement of the physician manned vehicle Patients who are subject to mechanical CPR from the time of device attachment Traumatic OHCA
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Chest compression depth | During cardiopulmonary resuscitation performed by emergency medical services, up to 4 hours | Chest compression depth is defined as the maximum posterior deflection of the sternum prior to chest recoil. Measured in centimeters and as percentage of compressions within the recommended 5 to 6 cm |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Return of spontaneous circulation (ROSC) | During cardiopulmonary resuscitation performed by emergency medical services, up to 4 hours | The return of a spontaneous pulse prior to handover at hospital measured as events |
| Sustained return of spontaneous circulation (ROSC) | During cardiopulmonary resuscitation performed by emergency medical services, up to 4 hours | The return of a spontaneous pulse at hospital handover measured as events |
| 30- day survival | 30 days from event | Patient alive at day 30 from event |
| Chest compression rate | During cardiopulmonary resuscitation performed by emergency medical services, up to 4 hours | Chest compression rate is defined as the frequency of chest compressions during compression series. Measured in number compressions per minute (cpm) and percentage of delivered compressions within the recommended rate of 100-120 cpm |
| Chest compression fraction | During cardiopulmonary resuscitation performed by emergency medical services, up to 4 hours | Chest compression fraction is defined as the time with chest compressions starting from the first therapeutic event to the end of the episode. An episode is the time without presence of a spontaneous patient pulse. Measured in percentage. |
Countries
Denmark
Outcome results
None listed