Out-of-hospital Cardiac Arrest Clinical Trial
Official title:
Comparison of Quality of Cardiopulmonary Resuscitation Between Flexible Stretcher and Standard Stretcher in Out-of-Hospital Cardiac Arrest: Ambulance Stretcher Innovation of Asian CPR (ASIA-CPR) Trial
This study aims to compare the quality of emergency medical services cardiopulmonary resuscitation between flexible stretcher and standard stretcher during ambulance transport to hospital among out-of-hospital cardiac arrest patients.
Background: Cardiopulmonary resuscitation (CPR) during ambulance transport in Asia has been
known to be ineffective for quality and unsafe for emergency medical services(EMS)providers.
Small elevators in high rise buildings are the most serious barriers to provide high quality
CPR due to too long stretcher cart to enter in the elevators. We developed flexible stretcher
cart to be safely used in small elevator through reducing the length of the stretcher. This
study aims to compare the quality of EMS CPR between flexible stretcher and standard
stretcher during transport to hospital.
Method:
This is a before and after-trial in a metropolis EMS. Study targets are adult out-of-hospital
cardiac arrest (OHCA), excluding evident death cases, pregnancy, DNR cases, and too big or
too small body size for stretcher cart or mechanical CPR devices. In the before period, the
standard stretcher will be used for manual CPR using standard CPR protocol. In the after
period, the flexible stretcher will be used with mechanical CPR devices after 3 cycles of
standard manual CPR. Individual and Utstein risk factors will be collected. Main outcomes are
no-flow fraction (NFF) measured by defibrillators (X-series) and safety will be measured on
mechanical error, transportation error, patient injury and EMS provider injury. Sample size
were 24 cases for before (12 cases) and after (12 cases) trial from 80% power and 0.05 of
alpha error for expecting 20% quality difference (30% NFF inflexible stretcher and 50% NFF in
standard stretcher)
Expected impact:
The study will be expected to find the benefit of flexible stretcher cart during CPR in small
elevators. This findings will contribute to revise the Asian EMS protocol for improving
quality of CPR.
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