Tele-intensivist consultation
OtherStandardized consultation to on-site cardiac arrest team by off-site intensivist via two-way audiovisual link using a mobile telemedicine cart
NCT Number: NCT03000829
This multicenter randomized trial will employ in-situ cardiac arrest simulations ("mock codes") to test whether using telemedicine technology to add an intensive care physician as the "copilot" for cardiac arrest resuscitation teams influences chest compression quality, resuscitation protocol adherence, team function, and provider experience.
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Notify Me18 year and older
All sexes
Interventional
Not applicable
American Fork Hospital, American Fork, Utah, United States
Only 15-30% of patients who suffer in-hospital cardiac arrest (IHCA) survive to hospital discharge. Factors associated with lower mortality and improved function include provision of high-quality, minimally-interrupted chest compressions and swift defibrillation of eligible arrhythmias. Unfortunately, resuscitation teams provide suboptimal care to 25-40% of IHCA victims. A dedicated IHCA team "copilot" may improve resuscitation team performance by providing the team leader with parallel analysis, situational awareness augmentation, action checking, protocol verification, and error correction. Critical care physician involvement via a telemedicine link could allow experienced specialists to fill the "copilot" role in a cost and resource-efficient manner, particularly in smaller hospitals with fewer available physicians.
The current study will evaluate how consultation by an off-site intensive care physician via a telemedicine link influences local IHCA teams' quality of care, team function and provider experience during simulated cardiac arrest events ("mock codes").
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
(on-site cardiac arrest team):
Inclusion criteria
(teleintensivist cardiac arrest team copilot):
Exclusion criteria
(both groups):
Standardized consultation to on-site cardiac arrest team by off-site intensivist via two-way audiovisual link using a mobile telemedicine cart
Display of silent, pre-recorded, non-interactive videotape of an ICU physician. The on-site cardiac arrest team will be told that an intensive care physician is observing the mock code.
Time frame: From initiation of intervention or placebo control until completion of two complete cycles of CPR (an average of 4 minutes)
Time frame: From onset of simulated VF or VT until first defibrillation or end of simulation
Time frame: From initiation of intervention or placebo control until completion of two complete cycles of CPR (an average of 4 minutes)
Time frame: From initiation of intervention or placebo control until completion of two complete cycles of CPR (an average of 4 minutes)
Time frame: From initiation of simulation through termination of simulation, an average of 15 minutes
Time frame: From initiation of simulation through termination of simulation, an average of 15 minutes
Time frame: From initiation of simulation through termination of simulation, an average of 15 minutes
Time frame: From initiation of simulation through termination of simulation, an average of 15 minutes
The validated "Team Emergency Assessment Measure (TEAM)" evaluates non-technical performance of the on-site resuscitation team. The score (range 0-4) for each simulation was obtained by averaging the mean score for each of 11 component scores (each component item scored 0-4, with higher values representing better performance).
Time frame: From initiation of simulation through termination of simulation, an average of 15 minutes
Time frame: Immediately after simulation
Measured domains: understanding of telemedicine intensivist copilot's role, beliefs about telemedicine intensivist copilot's ability to integrate with on site team, ability to influence on-site team performance, comfort with telemedicine intensivist copilot's role, and function of telemedicine interface
Time frame: Immediately after simulation
The short-form State-Trait Anxiety Inventory (STAI) measures acute stress experienced by respondents using 6 questions (scores for each question range from 1 to 4, with higher values indicating more stress). Analyzed respondent-level values use the total score (range 4-24) obtained by summing the score for each of the six questions, with higher values indicating more respondent-reported acute stress.
Time frame: From initiation of simulation through termination of simulation, an average of 15 minutes
Intermountain Health Care, Inc.
Other
Acronym: COPILOT-Sim
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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