Cardiac Arrest
Conditions
Keywords
cardiac arrest, cardiopulmonary resuscitation, telephone CPR, dispatch CPR, out-of-hospital cardiac arrest, defibrillation
Brief summary
RACE-CARS is a real-world cluster-randomized trial designed to evaluate a multifaceted community and health systems intervention aimed to improve outcomes of out-of-hospital cardiac arrest. RACE-CARS will enroll 50 counties in North Carolina that are estimated to have a total of approximately 20,000 patients with cardiac arrest over a 4-year intervention period. County "clusters" will be randomized in a 1:1 ratio to intervention versus usual care. The trial duration is 7 years, which includes a 6-month start-up (including recruitment and randomization) period, a 12-month intervention training phase, a 4-year intervention period, a 12-month follow-up for to assess quality of life in survivors of OHCA, and a 6-month close-out and data analysis period.
Interventions
OTHERRapid cardiac arrest recognition that triggers immediate priority EMS/first responder dispatch by 911 operators
EMS first responders will recognize cardiac arrest and respond immediately, increasing time to dispatch
OTHERSystematic bystander resuscitation instruction by 911 operators
911 operators will be able to describe how to administer CPR over the phone.
OTHERComprehensive community training of lay people in CPR and AED use.
Training of lay people regarding CPR and AED use.
OTHEROptimized first responder performance including earlier use of AEDs.
First responders will recognize where AEDs are located and use them appropriately
Sponsors
Duke University
National Heart, Lung, and Blood Institute (NHLBI)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* OHCA of non-traumatic etiology * Patients who are pulseless on arrival of a first responder; or patients who become pulseless in the presence of a first responder; OR patients who have a pulse on arrival of EMS, where a successful defibrillation was previously administered by a bystander or first responder.
Exclusion criteria
* Untreated cardiac arrests, including arrests in which resuscitation efforts are not initiated or are terminated immediately upon arrival of EMS because the patient is not a viable candidate for resuscitation due to: 1. injuries incompatible with life, 2. the presence of rigor mortis or lividity, 3. signs of decomposition, or 4. the presence of a valid DNR. * Private EMS transport that did not involve 911 dispatch (example: interfacility transport between nursing home and hospital). * Arrest of clear and obvious traumatic etiology * Bystander suspected cardiac arrest, where ROSC was achieved without the need for defibrillation or first responder CPR
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Survival with good neurologic outcomes as measured by a CPC score of 1 or 2 at discharge | up to 12months | Cerebral Performance Category (CPC) |
Secondary
| Measure | Time frame |
|---|---|
| Percent of patients who receive CPR from a bystander as measured by EMS report | Baseline |
| Rate of Defibrillation before paramedics arrive as measured by bystander interview | Baseline |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORChristopher Granger, MD
Duke University
Outcome results
None listed