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Completed

NCT Number: NCT03633370

Multifaceted Intervention for Increasing Performance of CPR by Laypersons in Out-of-hospital Cardiac Arrest

Cardiac arrest (CA) early recognition is essential in order to rapidly activate emergency services and for bystanders to begin cardiopulmonary resuscitation (CPR).

As soon as a call is received, EMS dispatchers should try to identify CA. This may be difficult, in a context of stress and distress of the person calling. Yet, it is vital for bystanders to initiate CPR. Survival can be multiplied by 2 to 4 if the bystanders initiate a CPR before the arrival of the emergency medical services.

This work aim to assess a multifaceted intervention combining 3 elements to improve the initial phone recognition of CA and raise the number of patients benefiting from CPR before EMS arrival on scene.

The first element is a dispatcher training to the early phone recognition of CA. This training will be based on the concept of active teaching, favouring the interactive work of learners in particular by listening to real dispatch recordings. It will be completed by continuing education with a distance teaching platform including the systematic listening of recorded CA calls.

The second element is based on the deployment of a software aiming to notify CA thanks to mobile phones. This system interfaced to a control software enables to request the participation of CPR-trained volunteers automatically. The volunteers have to be located in the patient's surroundings. The deployment of this mobile application will rely on first-aid volunteers, health personal and any trained volunteers willing to participate. A randomized control study in one city area proved the efficiency of a similar software to improve the proportion of CPR by bystanders.

The third element consists in a motivational feedback. A weekly overview of the management and the outcomes of patients who suffered CA will be broadcast to all the responders and volunteers in the mobile application.

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Key information

Conditions

Cardiac Arrest Cardiovascular Diseases Heart Arrest Heart Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

SAMU 80 - CHU Amiens Picardie, Amiens, France

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Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • All adults with nontraumatic, out-of-hospital cardiac arrest diagnosed during the emergency medical service call
  • Cardiac arrest located in urban area

Exclusion criteria

  • Pregnant or breastfeeding women
  • Patients under the law
  • Patients deprived of liberty by court ruling or administrative ruling
  • Traumatic cardiac arrest
  • CA occurring under the eyes of a professional emergency services patrol on duty
  • Cardiac arrest for which resuscitation seem unjustified (inevitable death, terminally ill irreversible condition, too long duration of cardiac arrest, non-resuscitation personal directive…)

Treatment and study plan

Multifaceted intervention including 3 components

Other

Multifaceted intervention including Dispatcher training to improve cardiac phone recognition, mobile application to send bystanders on cardiac arrest location before first professionals rescuers and motivational support for volunteer bystanders

Primary outcomes

  1. CPR initiated by bystanders before the arrival of first professionals rescuers

    Time frame: Day 0

    Proportion of patients who's received CPR initiated by bystander before EMS arrival.

Secondary outcomes

  1. Survival at 72h after out-of-hospital cardiac arrest

    Time frame: 72 hours

    survival at 72h

  2. Return of Spontaneous Circulation

    Time frame: Day 0

    Proportion of patients who's recovered a spontaneous circulation after CPR

  3. Survival to hospital admission

    Time frame: Day 0

    Vital status at hospital admission

  4. Survival to hospital discharge

    Time frame: up to 30 days

    Vital status at hospital discharge

  5. Survival at 30 days

    Time frame: 30 days

    Vital status at 30 days

  6. Neurological functional status CPC

    Time frame: up to 30 days

    As measured by Cerebral Performance Category (CPC) at hospital discharge and at 30 days Score less or equal to 2 will be considered as favorable neurological outcome

  7. Neurological functional status mRS

    Time frame: 30 days

    As measured by modified Rankin Scale (mRS) at hospital discharge and at 30 days:

    modified Rankin Scale (mRS): 0 - No symptoms.

    • - No significant disability. Able to carry out all usual activities, despite some symptoms.
    • - Slight disability. Able to look after own affairs without assistance, but unable to carry out all previous activities.
    • - Moderate disability. Requires some help, but able to walk unassisted.
    • - Moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted.
    • - Severe disability. Requires constant nursing care and attention, bedridden, incontinent.
    • - Dead Score less or equal to 3 will be considered as favorable neurological outcome

  8. First recorded rhythm

    Time frame: 30 min

    First recorded cardiac rhythm by EMS

Other outcomes

  1. Bystander's CPR quality

    Time frame: Day 0

    Evaluation of CPR quality performed by bystanders on a 4 points scale. CPR quality will be assessed by first professional rescuers on scene.

  2. Confirmation of cardiac arrest

    Time frame: Days 0

    The dispatcher CA's recognition will be confirmed by EMS on scene

  3. Automated External Defibrillator initiated before EMS arrival

    Time frame: Day 0

    Proportion of patients who's benefit to a automated external defibrillator before the EMS arrivals

  4. CPR initiation by witness without dispatcher Telephone-CPR

    Time frame: Day 0

    Evaluation of the proportion of patients with CPR initiated before EMS arrival without dispatcher Telephone-CPR

  5. CPR initiation by witness with Telephone-CPR

    Time frame: Day 0

    Evaluation of CPR initiated before EMS arrival following Telephone-CPR

  6. CPR initiation by app-activated bystanders

    Time frame: Day 0

    Evaluation of CPR initiated by bystanders, who are activated by the geo-localization application

  7. Proportion of cardiac arrest correctly identified after dispatch

    Time frame: 24 months

    Assessment of the evolution in CA recognition after the e-learning training

Sponsors and collaborators

Lead sponsor

University Hospital, Grenoble

Other

Registry information

Official study title

Multifaceted Intervention for Increasing Performance of Cardiopulmonary Resuscitation by Laypersons in Out-of-hospital Cardiac Arrest. A Stepped Wedge Cluster Randomized Controlled Trial

Acronym: DISPATCH

Important dates

Study start
2018
Primary completion
2022
Study completion
2022
First posted
Aug 16, 2018
Registry last updated
May 17, 2023

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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