Survival Study After Out-of-hospital Cardiac Arrest

Study Overview
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Brief Summary
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The purpose of this study is to determine if dual dispatch of ambulance, fire fighters and/or police in out-of-hospital cardiac arrest (OHCA), can reduce the time to cardiopulmonary resuscitation (CPR) and defibrillation, thus increasing survival.

Detailed Description
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Hypothesis If simultaneous dispatch of ambulance (EMS), firefighters and/or police is being initiated when an OHCA occurs, then the two latter units will be first at scene, before the ambulance crew, in ≥30% of the cases. We anticipate therefore that overall 30-days survival will increase on a national level from 9% to 12%. Method During the period 110901 to 141231 all OHCA cases will be analyzed were the emergency medical communication centre (EMCC) has dispatched ambulance, firefighters and/or the police. Participating in the Saving More Lives in Sweden (SAMS) project are the following counties: Stockholm, Sodermanland, Jonkoping, Vastra Gotaland (VG Region), Halland, Dalarna, Jamtland, Kalmar and Uppsala. Data is collected by the units being dispatched and thereafter sent on line to a database managed by Registercentrum in Gothenburg (http://www.registercentrum.se/), administrators of the Swedish Cardiac Arrest Register. Parameters obtained are: Time for dispatch of fire fighters and/or police (recorded digitally). Time for arrival to the patient. Verification if cardiac arrest or not. CPR performed by fire fighters or police before arrival of EMS. Automated External Defibrillator (AED) connected to the patient. If yes, was the first recorded rhythm shockable, i.e. ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). Time to defibrillation. Survival data during from the Swedish Cardiac Arrest Register (SCAR) will be obtained during the same time period from nine comparable Swedish regions not participating in the SAMS study.

Official Title
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Dual Dispatch of EMS, Fire Fighters and/or Police in Out-of-hospital Cardiac Arrest Implemented in Nine Counties in Sweden - Can More Lives be Saved by Using This Method?

Conditions
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Out-of-Hospital Cardiac Arrest

Intervention / Treatment
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* Other: Simultaneously dispatch of firefighters and/or police in case of OHCA


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All cases where the dispatcher suspects cardiac arrest, i.e. unconscious person with abnormal or no breathing Exclusion Criteria: Children < 8 y Obviously deceased persons according to regulations in EMS protocols

Ages Eligible for Study
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Minimum Age: 8 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

Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Dual dispatch<br>Simultaneously dispatching of EMS, firefighters and/or police in OHCA | Other: Simultaneously dispatch of firefighters and/or police in case of OHCA<br>* In case of OHCA, firefighters and/or police trained in CPR and equipped with AEDs will be dispatched in parallel with EMS in nine counties in Sweden.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Survival |  | 30-days after out-of-hospital cardiac arrest (OHCA) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time for dispatching of fire fighters and/or police | Data are obtained digitally from the dispatch center. | Up to 1 y after ending recruitement | 
| Time for arrival to the patient | Data are collected both digitally from the dispatch center and from protocols sent in on line by first responders. | Up to 1 y after ending recruitement | 
| Time for attaching the defibrillator to the patient | Data are collected from protocols sent in on line by first responders. | Up to 1 y after ending recruitement | 
| Time to first defibrillation | Data collected from the protocol sent in on line by first responders. | Up to 1 y after ending recruitement | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Police, Firefighters, Defibrillators, Survival, Cardiac Arrest, Out-of-Hospital Cardiac Arrest