Quality of the Cardio-pulmonary Resuscitation

Study Overview
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Brief Summary
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Patients having sudden cardiac arrest have very poor prognosis. It is devastating for patient and family. But also very expensive for nations economics when working-age people die or disable due to cardiac arrest. Recent studies have shown that high quality of cardiopulmonary resuscitation (CPR) and minimized delays increases the survival after cardiac arrest. In this objective prospective study we will use Zoll´s X Series defibrillator on every emergency medicine systems (EMS´s) unit in Pirkanmaa area, Finland, to collect information on CPR quality. Real CPR Help® will collect the information on depth, frequency and pauses during CPR. We will make an Utstein analysis on OHCA during one year period and compare the results on Utstein analysis made in the same area on 2013-2014. We will analyse the quality of CPR and compare it to the outcome from OHCA and neurological outcome 3 months after resuscitation. In addition we will analyse the CPR related injuries and compare these to the compression depth and number of persons performing CPR. In one part of the study we will evaluate the incidence of OHCA in different risk areas of Pirkanmaa and analyse the influence of time delay and location to the outcome out of hospital and neurological outcome 3 months after resuscitation. We will also analyse if the time of post-resuscitation care before getting to the hospital or stenosis in carotid artery affects the outcome from OHCA and neurological outcome 3 months after resuscitation.

Official Title
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Cardiopulmonary Resuscitation; Epidemiology, Quality, Survival and Injuries.

Conditions
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Cardiopulmonary Resuscitation

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: cardiac arrest > 18 years of age Exclusion Criteria: < 18 years of age prisoners

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cardiac arrest<br>All patients having sudden cardiac arrest out-of-hospital in Pirkanmaa, Finland | |
| ResusInj<br>OHCA survivors having CPR related injuries or carotid stenosis analyzed by CT | |
| ResusCPC<br>OHCA survivors neurological outcome | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| QualityCPR | The success rate of current guidelines (depth and frequency of chest compression, epidemiology) | 1 year | 
| Neurological survival after CA | Neurological survival after CA | 3 months after OHCA | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| CPR related injuries | Injuries detected in CT scanning or in autopsy | 1 year | 
| Stenosis of the carotid artery | Effect of the carotid artery stenosis to the neurological survival. Survivals having CPC 1-2 prior to the cardiac arrest and are taken to the ICU are scanned with carotid CTA after informed consent. The degree of stenosis will be compared to the CPC-level 3monts aften OHCA. | 3 months after OHCA | 
| the dispatch calls concerning OHCA | Analyze the key words and dispatch assisted CPR through the emergency call. All emergency call conserning OHCA patients will be listened. We will analyze the keywords which are used by layperson to describe patient having cardiac arrest. We will also analyze the amount of given dispatch assisted CPR and compare the amount to the primary rythm. | 1 year | 
| the quality of the postresuscitation care | The correlation of the duration and the quality of the postresuscitation care before getting in to the hospital and the outcome from OHCA | 3 months after OHCA | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CPR, injuries, OHCA