Cardiac Arrest Clinical Trial
Official title:
Prospective Deployment of a Cardiac Arrest Response System (EDICARS) in the Emergency Department: A Cluster Randomized Controlled Trial
Based on data from the American Heart Association's (AHA) Get With the Guidelines-Resuscitation (GTWG-R) registry, the incidence of adult treated in-hospital cardiac arrest (IHCA) was about 10 per 1,000 bed-days (290,000 patients per year), and 15 to 20% of adult IHCA patients survived to hospital discharge (i.e., ~80% mortality). Despite the significant morbidity and mortality caused by IHCA, ED-based IHCA is surprisingly less studied. The investigators have utilized electronic medical record (EMR)'s big data (>700,000 visits) from our hospital to investigate, for the first time, the epidemiology and outcome of IHCA in the ED in Taiwan. The investigators also have developed and validated a simple prediction tool for ED-based IHCA, the Emergency Department In-hospital Cardiac Arrest Score (EDICAS). This tool has also been externally validated using Far Eastern Memorial Hospital's ED data. In addition, the investigators also have developed and validated a vital-sign trajectory-based longitudinal model (group-based trajectory modeling [GBTM]) to predict ED-based IHCA. Based on these studies, the investigators now propose to (1) Embed the EDICAS into our hospital information system (HIS) in real-time at ED triage to identify high-risk patients (EDICAS 6+); and (2) Distribute wearable smart wristbands to high-risk patients to augment vital signs monitoring and send alerts based on GBTM results. The detection and intervention components together form the rapid response system, the Emergency Department In-hospital Cardiac Arrest Response System (EDICARS). In this study, the investigators will enroll and randomize 10 attending physicians into the EDICARS or the usual care arm for 3 months, with each of them treating 100 patients (patients clustered within physicians). The trial will stop for 2 months as a wash-out period, and an interim analysis will be performed. The physicians will then cross over, and each of them will treat 100 patients for another 3 months. A total of 2,000 adult patients will be enrolled. The primary outcome is a composite rate of ED-based IHCA and intensive care unit (ICU) admission. The secondary outcomes include time from ED triage to ED-based cardiac arrest, ICU and hospital length of stay, early ward-based IHCA, and early ICU transfer.
n/a
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT06048068 -
Removing Surrogates' Uncertainty to Reduce Fear and Anxiety After Cardiac Events
|
N/A | |
Recruiting |
NCT05558228 -
Accuracy of Doppler Ultrasound Versus Manual Palpation of Pulse in Cardiac Arrest
|
||
Completed |
NCT03685383 -
Cytokine Adsorption in Post-cardiac Arrest Syndrome in Patients Requiring Extracorporeal Cardiopulmonary Resuscitation
|
N/A | |
Completed |
NCT04584645 -
A Digital Flu Intervention for People With Cardiovascular Conditions
|
N/A | |
Completed |
NCT04619498 -
Effectiveness of an Interactive Cognitive Support Tablet App to Improve the Management of Pediatric Cardiac Arrest
|
N/A | |
Not yet recruiting |
NCT05649891 -
Checklists Resuscitation Emergency Department
|
N/A | |
Withdrawn |
NCT02352350 -
Lactate in Cardiac Arrest
|
N/A | |
Completed |
NCT03024021 -
Cerebral Oxymetry and Neurological Outcome in Therapeutic Hypothermia
|
||
Completed |
NCT02275234 -
Care After Resuscitation
|
||
Completed |
NCT02247947 -
Proteomics to Identify Prognostic Markers After CPR and to Estimate Neurological Outcome
|
||
Completed |
NCT01944605 -
Intestinal Ischemia as a Stimulus for Systemic Inflammatory Response After Cardiac Arrest
|
N/A | |
Completed |
NCT01972087 -
Simulation Training to Improve 911 Dispatcher Identification of Cardiac Arrest
|
N/A | |
Completed |
NCT01936597 -
Prospective Study of 3 Phone Assistance Strategies to Achieve a Continuous Cardiac Massage
|
N/A | |
Active, not recruiting |
NCT01239420 -
Norwegian Cardio-Respiratory Arrest Study
|
||
Completed |
NCT00880087 -
Therapeutic Hypothermia to Improve Survival After Cardiac Arrest in Pediatric Patients-THAPCA-IH [In Hospital] Trial
|
N/A | |
Completed |
NCT00878644 -
Therapeutic Hypothermia to Improve Survival After Cardiac Arrest in Pediatric Patients-THAPCA-OH [Out of Hospital] Trial
|
Phase 3 | |
Completed |
NCT01191736 -
Ultra-Brief Versus Brief Hands Only CPR Video Training With and Without Psychomotor Skill Practice
|
N/A | |
Completed |
NCT00729794 -
Vasopressin, Epinephrine, and Steroids for Cardiac Arrest
|
Phase 3 | |
Recruiting |
NCT00441753 -
Cerebral Bloodflow and Carbondioxide Reactivity During Mild Therapeutic Hypothermia in Patients After Cardiac Arrest
|
N/A | |
Completed |
NCT00347477 -
Fluid Shifts in Patients Treated With Therapeutic Hypothermia After Cardiac Arrest
|
Phase 3 |