Improving Bystander CPR Quality Through Dispatcher-assisted Basic Life Support Education Program

Out-of-Hospital Cardiac Arrest Clinical Trial

Official title:

Improving Bystander CPR Quality Through Dispatcher-assisted Basic Life Support Education Program

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02527473
• Other study ID #: SNUH-EM-2014-2498
• Status: Completed
• Phase: N/A
• First received: August 4, 2015
• Last updated: August 17, 2015
• Start date: November 2014
• Est. completion date: August 2015

Study information

• Verified date: August 2015
• Source: Seoul National University Hospital
• Contact: n/a
• Is FDA regulated: No
• Health authority: Korea: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

In an attempt to enhance OHCA survival by increasing bystander CPR rate, this study will assess the effectiveness of the new basic life support with dispatch assistance (DA-BLS) education program through a simulation experiment.

This study aims to determine whether the new DA-BLS program for possible home bystanders is associated with improved CPR quality. We expect home bystanders who were trained with new DA-BLS education program to show better compliance with CPR instructions given by dispatcher via telephone along with improved CPR quality.

Description:

Bystander cardiopulmonary resuscitation (CPR) is a crucial component of survival after out-of hospital cardiac arrest (OHCA). Not only the rate of bystander CPR has been associated with higher OHCA survival rate, but the quality of bystander CPR as measured by proportion of correct chest compression and earlier administration has been highly indicative of positive outcomes as well.

However, bystander CPR rates have been reported to be low in many communities due to low access to CPR training. To address this, among many attempts to improve OHCA survival, enhancing bystander CPR rate and quality through dispatcher-assisted CPR (DA-CPR) to the right target group may be an effective and promising approach.

In DA-CPR, the dispatcher on the emergency line provides CPR instruction over the phone. Over-the-telephone CPR instruction was intended to primarily benefit bystanders who have little or no training, but studies have shown that it can also benefit trained bystanders who are in panic in emergency situations to prompt CPR administration. Trained bystanders who received dispatcher assistance during CPR also showed improved CPR quality.

Previous studies reported that 50-81% of OHCA occurs at home. However, the outcome in private homes was very poor compared to outside private home including public places. One possible reason of such lower survival rate may be that the current CPR education programs for home bystanders are inefficient in properly educating home bystanders to provide quality CPR to the patient. In other words, despite the reported benefits of DA-CPR in both trained and untrained bystanders, performing bystander CPR according to phone instruction provided by the dispatcher may not be easy to follow for certain home bystanders such as women and elderly.

According to a recent analysis of 2012 National OHCA Registry, outcomes after OHCA were significantly lower (adjusted odds ratio; 0.36, 95% confidence intervals; 0.18-0.71) in patients who received home bystander CPR with dispatcher assistance than in patients who received either public or who received home bystander CPR without dispatcher assistance. These results suggest that home bystander CPR with dispatcher assistance did not improve the outcomes due to low compliance of CPR instruction and low CPR performance quality by home bystanders. Considering that the in-home OHCA patients are less likely to receive bystander CPR, there needs a new approach to optimize the low compliance rate and CPR quality in possible home bystanders.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 24
• Est. completion date: August 2015
• Est. primary completion date: July 2015
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Both
• Age group: 35 Years and older

Eligibility

Inclusion Criteria:

• Female Seoul residents aged between 35-65 years who are primarily a stay-at-home housewife without regular income OR

• Elderly Seoul residents who are older than 65 years old

Exclusion Criteria:

• No prior CPR training

Study Design

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor)

Related Conditions & MeSH terms

• Cardiopulmonary Resuscitation
• Heart Arrest
• Out-of-Hospital Cardiac Arrest

Intervention

Other:
• Dispatcher-Assisted Basic Life Support CPR Education
The training program focuses on working in a team with a dispatcher, re-enacting all steps during an emergency call from recognition of cardiac arrest to performing CPR. The one hour training session is split into four parts: Video self-instruction manikin practice (30 min), including a brief introduction to AED. Practice in pairs (15 min): Role-playing a simulated emergency scenario as the dispatcher and the rescuer Debriefing (15 min): Questions, answers and reflection Homework: Information leaflet handed out including at-home tasks such as operating the speakerphone function on the layperson's own phone

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Seoul National University Hospital

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change of total no flow time at 6 months		Baseline and 6 months	No
Secondary	Change of proportion of correct chest compression at 6 months		Baseline and 6 months	No