Relevance of Reversible Causes During OHCA (Rebecca Study)

Study Overview
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Brief Summary
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Management of the reversible causes in cardiac arrest is fundamental for successful treatment of out-of-hospital cardiac arrests. Point-of-care diagnostics as prehospital emergency ultrasound, blood gas analysis and toxicological screening support the diagnostic process of evaluating potential reversible causes. Digital tools provide support of a structured approach. This study aims to evaluate the frequency of reversible causes during OHCA as well as specific interventions due to these findings. Furthermore, CPR performance (hands-off, ROSC, 30-day mortality) and cognitive load of the prehospital emergency physician will be investigated. In total 100 patients with OHCA will be included in this study. Identification of reversible causes will be performed upon a structured protocol using an interactive checklist. Cognitive load of emergency physician as well as CPR parameter (frequency of reversible causes, hands-off, ROSC, 30-day mortality) will be analysed.

Official Title
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Relevance of Reversible Causes During OHCA (Rebecca Study)

Conditions
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Out-Of-Hospital Cardiac Arrest, Cardiopulmonary Arrest

Intervention / Treatment
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* Diagnostic Test: Checklist for evaluation of reversible causes


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with prehospital cardiac arrest, where POCUS, blood gas analysis as well as screening for intoxication can integrated in ALS rhythm without delay of life-saving treatment or transportation will be included. Exclusion Criteria: Patients will be excluded under the age of 18, or if POCUS, blood gas analysis will lead to a delay of live-saving treatment or transportation. Furthermore, pregnant patients will be excluded.

Ages Eligible for Study
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Minimum Age: 18 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: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Evaluation of reversible causes using digital checklist and diagnostic support<br> | Diagnostic Test: Checklist for evaluation of reversible causes<br>* Prehospital evaluation by checklist and diagnostic testing for reversible causes of OHCA using point-of-care blood gas analysis, saliva toxicological screen and ultrasound and post-hoc toxicological analysis of blood using mass spectrometry<br>* Other names: Point-of-care ultrasound;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency of reversible causes in OHCA and alterations of treatment | The primary outcome of this study evaluates the frequency of reversible causes during OHCA. | up to 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency of ROSC | Any prehospital ROSC/sustained ROSC/in-hospital ROSC | up to 30 days | 
| 30-day mortality | rate of mortality within 30 days in case of hospital admission | up to 30 days | 
| Hands-off time | Hands-off time during process of identification of reversible causes | During study completion, up to 120 min | 
| Cognitive load | NASA Task Load Index evaluated by the prehospital emergency physician after rescue mission | 1 year (evaluation in documentation phase after CPR) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CPR, Intoxication, Prehospital POCUS, Sonography, Blood gas analysis, Cardiac arrest, OHCA, Reversible causes, Tele-support, Checklist, Prehospital emergency physician, Emergency medicine