Effects of a New Dispatcher-Assisted Basic Life Support Training Program

Study Overview
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Brief Summary
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Despite aggressive cardiopulmonary resuscitation (CPR) training, the outcome of cardiac arrest is not good. The problem is method of education. So, the investigators want to add the dispatcher-assisted CPR simulation into conventional CPR training. In this study, the study is aimed to investigate the effect of newer CPR training program.

Detailed Description
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The training program focuses on working in team with dispatcher, performing all steps from recognizing cardiac arrest to performing CPR, together with the dispatcher. The one hours training session is split into four parts: Video self-instruction manikin practice (30 min), including a brief introduction to automated external defibrillator (AED). Practice in pairs (15 min). Practicing the dispatcher and rescuer role in a simulation to enhance learning. Debriefing. Questions, answers and reflection (15 min). Homework. Leaflet with tasks like learn how to activate the speaker function on your own phone. The main difference between dispatcher-assisted basic life support (DA-BLS) and traditional BLS training is that DA-BLS provides the scenes and interactive experiences on calling emergency medical service (EMS) and receiving CPR instruction via telephone speaker function, following up the skill training by scenario simulation training.

Official Title
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Clinical Effects of a New Dispatcher-Assisted Basic Life Support Training Program in a Metropolitan City: A Before-and-After Intervention Study

Conditions
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Out of Hospital Cardiac Arrest

Intervention / Treatment
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* Other: BLS CPR program with dispatcher assisted CPR simulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All out-of-hospital cardiac arrest (OHCA) patients with presumed cardiac etiology who are 19 years of age or older and assessed and treated by EMS providers after dispatched by the EMS dispatch center will be included. Exclusion Criteria: We will exclude patients with non-cardiac etiology, prolonged cardiac arrest with a suspected duration more than 30 minutes, cases such as livor mortis or rigor mortis, and decapitated or decomposed body, and patients who have Do-Not-Resuscitate card documented by doctor.

Ages Eligible for Study
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Minimum Age: 19 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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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: New DA-BLS training program<br>A one-hour training course that includes a 30-minute video-based self-instruction (VSI) training session, a short role-play, and a debriefing. The video consists of a bystander CPR simulation with dispatcher instructions using the trainee's own phone and practice session following demonstration by a simulated layperson. After watching the video clip, all trainees are divided into two groups and conduct a role-play as dispatchers and laypersons for 15 minutes. Finally, there is a 15-minute debriefing session with several assignments. The HEROS program focuses on cooperation with a dispatcher, from recognition of cardiac arrest to performing DA-CPR, with hands-on practice so that laypersons can provide bystander CPR immediately in a real situation. Moreover, the HEROS program emphasizes practice for providing the correct address of the scene and switching to speakerphone mode, especially for the elderly. | Other: BLS CPR program with dispatcher assisted CPR simulation<br>* the training program more focuses on cooperation with a dispatcher, from recognition to perform DA-CPR and hands-on practice.<br>|
| No Intervention: Current Basic Life Support (BLS) training program<br>A one-hour training program that was developed by the Korea Center for Disease Control and Prevention (CDC) and it was based on the American Heart Association (AHA) guideline (http://www.cdc.go.kr/board.es?mid=a20503050000&bid=0021&tag=&act=view&list_no=127655). The program consists of a 30-minute VSI, and a 30-minute practice debriefing session. It focuses on detailed techniques for performing high-quality chest compressions including the correct hands and body position of the bystanders. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants Surviving to Hospital Discharge | The study end points are survival to hospital discharge. Survival to discharge will be measured as proportions of patients who were discharged from a hospital with their spontaneous circulation recovered. This information will be collected from medical record review. | from date of discharge, assessed up to 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants With Return of Spontaneous Circulation (ROSC) | The return of spontaneous circulation will be measured as proportion of the patients who were recovered their circulation at emergency department. This information will be collected from the medical review. | from date of cardiac arrest occurred, assessed up to 1 week | 
| Number of Participants With Good Neurological Recovery | The Cerebral Performance Categories (CPC) score will be used to measure neurological recovery status: CPC 1 (good cerebral performance), CPC 2 (moderate cerebral disability), CPC 3 (severe cerebral disability), CPC 4 (coma or vegetative state), CPC 5 (brain death). We defined the good neurological recovery as CPC 1 or CPC 2. This information will be collected from medical record review. | from date of discharge, assessed up to 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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survival, cardiac arrest, dispatcher-assisted bystander cardiopulmonary resuscitation