Out-of-Hospital Cardiac Arrest Clinical Trial
Official title:
Arizona Prehospital CPR Quality Improvement Project
The quality of cardiopulmonary resuscitation (CPR) provided to patients with out-of-hospital
cardiac arrest (OHCA) is often suboptimal. There now exist monitors/defibrillators that allow
for the measurement and real time feedback of the quality of chest compressions and
ventilations. In addition to giving the prehospital provider the benefit of real time CPR
quality feedback via voice and visual cues, the CPR quality data acquired using these devices
can be utilized as part of an on-going quality assurance/quality improvement program.
The first objective of the proposed project is to quantify the quality of chest compressions
and ventilations provided in the state of Arizona to patients with OHCA and to determine
whether the quality of CPR is related to patient outcome from OHCA.
A second objective of this project is to determine whether use of audiovisual feedback
improves both CPR quality and patient outcome in the pre-hospital setting.
Phase I: In the first phase of the project, the EMS systems will utilize the E-series units
to treat all patients with OHCA. The audiovisual feedback prompts will be inactivated during
this phase. The EMS providers will be instructed to follow the standard CCR protocol, as is
currently the practice. Aside from the change in monitor/defibrillator equipment, the
treatment of OHCA patients during this phase will be identical to the treatment that is
currently performed. The quality of CPR will be measured using the accelerometer-based
system. The data will be stored in the defibrillator and will be downloaded upon completion
of the call. The first phase will be conducted for approximately 6 months from the time each
site initiates the use of the E-series monitor/defibrillators.
Phase 2:In the second phase of the project, the EMS providers will undergo training on how to
use the audiovisual feedback prompts. The providers will continue to treat patients according
to the CCR protocol but will now receive audio and/or visual feedback on the quality of CPR
that they are performing. The providers will select the preferred feedback method(s) - audio,
visual or both. As in phase I, the CPR data will be stored in the defibrillator and will be
downloaded upon completion of the call.
The total number of EMS personnel who will be trained is approximately 450. In Phase I, there
were 219 OHCAs (80% from Mesa Fire Dept, and 20% from Guardian Medical Transport). So far in
Phase II, there have been about 100 OHCAs.
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