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Active, Not Recruiting

NCT Number: NCT03894059

An Educational Program to Improve Cardiac Arrest Diagnostic Accuracy of Ambulance Telecommunicators

Cardiac arrest is the number one cause of death in Canada. It is often the first symptom of cardiac disease for the victims. Eighty-five percent of victims collapse in their own home. Fifty percent collapse in the presence of a family member. Bystander cardiopulmonary resuscitation (CPR) can improve the chance to survive a cardiac arrest by three to four times, but needs to be started quickly. In most communities, less than 30% of victims receive CPR before the ambulance arrives. Currently, only 8% of cardiac arrest victims can leave the hospital alive.

Many things have been tried to improve the number of times people do CPR. So far, the only thing that really increased the number of times that someone did CPR is when 9-1-1 attendants started to give CPR instructions to callers over the phone. The only problem is that about 25% of cardiac arrest victims gasp for air in the first few minutes. This can fool the 9-1-1 callers and attendants into thinking that the victim is still alive.

The investigators have looked at all the studies on how to help 9-1-1 attendants to recognize abnormal breathing over the phone. The investigators have also learned what should be taught after finishing a large survey with 9-1-1 attendants from across Canada. This survey was done with the help of psychologists and other education experts. It measured the impact of attitudes, social pressures, and 9-1-1 attendants' perceived control over their ability to recognize abnormal breathing and cardiac arrest. Then the investigators developed a teaching tool which helped Ottawa 9-1-1 attendants recognize abnormal breathing. When they could do that, they could also recognize more cardiac arrest.

The main goal of this project is to use the tool developed in Ottawa in more centres to help 9-1-1 attendants save the lives of even more cardiac arrest victims across Canada.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Age range

16 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Emergency Medical Care Inc.

Dartmouth, Nova Scotia, B3B 2B2, Canada

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

We will enroll ALL patients with prehospital cardiac arrest (absence of a detectable pulse, unresponsiveness, and apnea):

  • That are of presumed cardiac origin;
  • That occur in the catchment area of our participating sites; and
  • For which resuscitation is attempted by a bystander and/or the emergency responders.

Exclusion criteria

  • Cardiac arrest witnessed by paramedics after their arrival (no opportunity for bystander intervention);
  • Patients younger than 16 years of age (cardiac arrest usually respiratory and rare in this population);
  • Patients who are "obviously dead";
  • Trauma victims, including hanging and burns; or
  • Patients with cardiac arrest clearly of other non-cardiac origin including drug overdose, carbon monoxide poisoning, drowning, exsanguination, electrocution, asphyxia, hypoxia related to respiratory disease, cerebrovascular accident and documented terminal illness.

Treatment and study plan

Educational Intervention

Other

Additional training provided to ambulance telecommunicators in participating sites to help increase recognition of agonal breathing in the presence of out-of-hospital cardiac arrest.

Primary outcomes

  1. Overall Survival

    Time frame: Change between 12 month period before and after delivery of additional education to ambulance telecommunicators

    Accessing hospital medical records or coroner's reports, assess survival of cardiac arrest victim as being discharged alive from hospital.

Secondary outcomes

  1. Community Bystander Cardiopulmonary Resuscitation Rate

    Time frame: Change between 12 month period before and after delivery of additional education to ambulance telecommunicators

    The first member of the emergency response team to arrive at the scene will document whether or not chest compressions have been initiated by someone prior to the arrival of the emergency team.

  2. Telecommunication-assisted CPR instructions rate

    Time frame: Change between 12 month period before and after delivery of additional education to ambulance telecommunicators

    By reviewing audio recordings, determine the cases where telecommunicator assistance led to delivery of chest compressions

  3. Presence of agonal breathing

    Time frame: Change between 12 month period before and after delivery of additional education to ambulance telecommunicators

    Document the presence or absence of agonal breathing through review of audio recording.

  4. Cardiac arrest recognition rate

    Time frame: at time of event

  5. Time intervals

    Time frame: Change between 12 month period before and after delivery of additional education to ambulance telecommunicators

    call receipt to recognition of cardiac arrest, time to CPR instructions initiated

Sponsors and collaborators

Lead sponsor

Ottawa Hospital Research Institute

Other

Collaborators

  • Alberta Health services
  • BC Emergency Health Services
  • Emergency Health Services Nova Scotia
  • Health PEI
  • Medacom Atlantic
  • Ontario Ministry of Health and Long Term Care
  • Providence Health Care, British Columbia

Registry information

Official study title

Multi-Center Implementation of an Educational Program to Improve the Cardiac Arrest Diagnostic Accuracy of Ambulance Telecommunicators and Survival Outcomes for Sudden Cardiac Arrest Victims

Important dates

Study start
2020
Primary completion
2025
Study completion
2025
First posted
Mar 28, 2019
Registry last updated
Oct 29, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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