The Scandinavian AED and Mobile Bystander Activation Trial
Condition: Out-Of-Hospital Cardiac Arrest; Cardiac Arrest, Sudden
MeSH terms: Heart Arrest; Out-of-Hospital Cardiac Arrest; Death, Sudden, Cardiac
Study type: Interventional

Summary: 
      Sudden cardiac death is a major health problem in the western world. In Europe alone nearly
      300 000 patients are affected annually. The majority of victims suffering from an
      Out-of-Hospital Cardiac Arrest (OHCA have an initial cardiac rhythm that can be treated by
      means of defibrillation. In most emergency medical systems (EMS) time to defibrillation is
      too long and survival averages 10 %.However, when laymen operated Automated External
      Defibrillators (AEDs) are used within the first minutes, 7 out of 10 may survive.

      The aim of "The Scandinavian AED and Mobile Bystander Activation" (SAMBA) trial is to
      evaluate if a Mobile Phone Positioning system and a smartphone application will increase the
      proportions of patients with an attached Automated External Defibrillator (AED) before
      arrival of the Emergence Medical System (EMS). Mobile phone technology and a smartphone
      application will be used identify and recruit nearby CPR-trained lay people and automated
      external defibrillators (AEDs) to patients suffering out-of-hospital cardiac arrest (OHCA).
      The system is currently running in Stockholm Sweden and in the Gothenburg region.
    

Detailed description: 
      Early defibrillation in out-of-hospital cardiac arrest is associated with high survival
      rates. If the operator at the dispatch center suspects an out-of-hospital cardiac arrest he
      or she will activate the mobile positioning system (MPS) wich is integrated in the operators
      computer environment.

      After activation, the system will locate all CPR-trained volunteers nearby the suspected
      OHCA. By computer based 1:1 randomization lay volunteers will be alerted and dispatched in 50
      % of all suspected OHCAs in where the system is triggered by the dispatchers. In the
      intervention group, the activation of the system is supposed to result in lay volunteers to
      be alerted and directed to fetch the nearest AED and commence early defibrillation. Dependent
      on geographical and logistical circumstances, at a minimum one lay volunteer or more will be
      alerted to provide bystander CPR only.

      In the control group the MPS will be activated and lay responders will be dispatched to
      suspected OHCA to perform CPR only. In both groups the ordinary EMS services are dispatched
      in a regular fashion.
    

Intervention name(s): Layperson allocated to start CPR and fetch nearest AED; Layperson allocated to start CPR
Intervention type(s): Device; Device
Intervention description(s): Dispatching laypersons to fetch an AED and start CPR in out-of-hospital cardiac arrest; Dispatching laypersons to start CPR out-of-hospital cardiac arrest
Other intervention name(s): Dispatch to start CPR and fetch nearest AED; Dispatch to start CPR
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Care Provider, Investigator)
Primary purpose: Treatment