Clinical trial NCT02184468: Survival Study After Out-of-hospital Cardiac Arrest
Official title: 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?
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Out-of-Hospital Cardiac Arrest
Keywords: Cardiac Arrest
Out-of-Hospital Cardiac Arrest
Firefighters
Police
Defibrillators
Survival
Lead sponsor: Karolinska Institutet
Sponsor class: OTHER
Collaborators: name: The Laerdal Foundation for Acute Medicine in Norway
name: Swedish Heart Lung Foundation
name: Ministry of Health and Social Affairs, Sweden
name: Swedish Association of Local Authorities and Regions
First posted: 2014-07-09
Enrollment: 6000
Sex: ALL
Minimum age (years): 8
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP

Brief summary: 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: 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.

Eligibility criteria: 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

Primary outcomes:
measure: Survival
timeFrame: 30-days after out-of-hospital cardiac arrest (OHCA)
Secondary outcomes:
measure: Time for dispatching of fire fighters and/or police
timeFrame: Up to 1 y after ending recruitement
measure: Time for arrival to the patient
timeFrame: Up to 1 y after ending recruitement
measure: Time for attaching the defibrillator to the patient
timeFrame: Up to 1 y after ending recruitement
measure: Time to first defibrillation
timeFrame: Up to 1 y after ending recruitement
Other outcomes:
Locations:
city: Stockholm
country: Sweden
facility: Center for Resuscitation Science, Sodersjukhuset
Study officials:
affiliation: Center for Resuscitation Science, Karolinska Institutet, Stockholm, Sweden
name: Leif Svensson, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Hasselqvist-Ax I, Nordberg P, Herlitz J, Svensson L, Jonsson M, Lindqvist J, Ringh M, Claesson A, Bjorklund J, Andersson JO, Ericson C, Lindblad P, Engerstrom L, Rosenqvist M, Hollenberg J. Dispatch of Firefighters and Police Officers in Out-of-Hospital Cardiac Arrest: A Nationwide Prospective Cohort Trial Using Propensity Score Analysis. J Am Heart Assoc. 2017 Oct 4;6(10):e005873. doi: 10.1161/JAHA.117.005873.