Arizona Prehospital CPR Quality Improvement Project
Condition: Out-of-Hospital Cardiac Arrest
MeSH terms: Heart Arrest; Out-of-Hospital Cardiac Arrest
Study type: Observational

Summary: 
      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.
    

Detailed description: 
      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.
    

Intervention name(s): Audiovisual Feedback
Intervention type(s): Other
Intervention description(s): EMTs will get audiovisual feedback on CPR technique during CPR
Observational model: Other
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Emergency medical services providers in 4 different Arizona cities
      
Keywords: Out-of-Hospital Cardiac Arrest, OHCA