Heart Arrest Clinical Trial
Official title:
Randomized Trial of Dispatcher-Assisted CPR:Chest Compression Alone Versus Chest Compression Plus Ventilation
The purpose of this study is to determine whether dispatcher-assisted CPR instructions with compressions and ventilations versus dispatcher-assisted CPR instructions with compressions only improves survival from out-of-hospital cardiac arrests.
Out-of-hospital cardiac arrest, a condition characterized by a person suddenly collapsing
due to heart stoppage, is a leading cause of death in the United States. In out-of-hospital
cardiac arrest, survival is dependent upon what the American Heart Association has termed
the chain of survival which includes quick activation of the 9-1-1 system, prompt
cardiopulmonary resuscitation (CPR), early defibrillation, and qualified advanced life
support care (paramedic care). CPR allows for some circulation and delivery of oxygen to
vital organs when the heart is no longer beating on its own. However, in some instances, the
citizen bystander has not been trained in CPR, presenting a circumstance where the cardiac
arrest victim may not receive CPR until the arrival of emergency medical services (EMS)
personnel (i.e., paramedics). The delay in CPR adversely affects outcome and dcreases the
chance of survival. In response to this need, the EMS Division of Public Health - Seattle
and King County developed and instituted telephone CPR instructions that could be provided
"on-the-spot" during a cardiac arrest by the emergency medical (9-1-1) dispatcher. The
instructions are designed to be given over the phone to persons who have not had previous
CPR training so that they can initiate CPR prior to the arrival of EMS personnel and have
been termed "dispatcher-assisted" CPR. The dispatcher instructions provided by the dispatch
agencies of King County include the standard "full" CPR protocol of ventilations (breathing
into the victim's mouth to inflate the lungs) and chest compressions(pumping on the patients
chest to help circulate the blood). The ventilations oxygenate the blood while the chest
compressions pump the oxygenated blood forward. This EMS program has led to a considerable
increase in the proportion of cardiac arrest victims in King County that receive citizen
bystander CPR prior to EMS arrival and has been associated with improved survival (appendix
1).
Comparison: Dispatcher-assisted CPR instructions with compressions and ventillations
compared to dispatcher-assisted CPR instructions with compressions only.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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