Clinical trial NCT00138996: Quality of Cardiopulmonary Resuscitation Without and With Defibrillator Feedback
Official title: Can the Quality of Cardiopulmonary Resuscitation Improve With Direct Online Feedback From the Defibrillator to the Rescuers on Their Resuscitation Efforts
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Cardiac Arrest
Keywords: cardiac arrest
resuscitation
quality
feedback
training
Lead sponsor: University of Oslo
Sponsor class: OTHER
Collaborators: name: Laerdal Medical
name: Ullevaal University Hospital
name: Health Region East, Norway
name: Norwegian Air Ambulance Foundation
name: London Ambulance Service
name: Stockholm Ambulance Service
name: University of Chicago
First posted: 2005-08-30
Enrollment: 300
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: Quality of bystander cardiopulmonary resuscitation (CPR) affect patient survival. Quality of professional CPR on patients has not been studied in detail, but it is regularly reported that the quality when tested on manikins deteriorates dramatically within months after training. Automated direct feedback on CPR quality from manikins brings quality back within a couple of minutes. Similar feedback has been incorporated into a defibrillator which also monitors quality of CPR. We hypothesise that quality of professional clinical CPR improves with such feedback

Detailed description: Defibrillators which monitor quality of CPR via changes in thoracic impedance (for ventilation) and movement of the sternum employing an accelerometer (for chest compressions) will be employed in ambulances in Akershus county (Norway), Stockholm (Sweden) and London (UK). During phase 1 quality of CPR will be monitored without feedback from the defibrillator. During phase 2 the ambulance personnel will receive feedback via the defibrillator. During phase 3 the ambulance personnel will be retrained with particular attention to the quality problems that became apparent in phase 3.

Quality of CPR will be continuously recorded by the defibrillators and the data collected and sent via internet to Laerdal Medical. All other cardiac arrest data including survival will be recorded using standard datasets for cardiac arrest research as developed by a task force with members from the organisations in International Liaison Committee on resuscitation (Utstein guidelines). The data will be annotated and analyzed in detail by researchers at University of Oslo

Eligibility criteria: Inclusion Criteria:

* Cardiac arrest out-of-hospital

Exclusion Criteria:

* \< 18 years old

Primary outcomes:
measure: fraction of time without CPR
measure: chest compression depth
measure: chest compression frequency
measure: chest compression/decompression duty cycle
measure: ventilation frequency
Secondary outcomes:
measure: rate of return of spontaneous circulation
Other outcomes:
Locations:
city: Oslo
country: Norway
facility: Ulleval University Hospital
city: Stockholm
country: Sweden
facility: Stockholm Ambulance Service
city: London
country: United Kingdom
facility: London Ambulance Service
Study officials:
affiliation: University of Oslo, Ulleval University Hospital
name: Petter A Steen
role: PRINCIPAL_INVESTIGATOR
References:
citation: Wik L, Kramer-Johansen J, Myklebust H, Sorebo H, Svensson L, Fellows B, Steen PA. Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA. 2005 Jan 19;293(3):299-304. doi: 10.1001/jama.293.3.299.
citation: Kramer-Johansen J, Edelson DP, Abella BS, Becker LB, Wik L, Steen PA. Pauses in chest compression and inappropriate shocks: a comparison of manual and semi-automatic defibrillation attempts. Resuscitation. 2007 May;73(2):212-20. doi: 10.1016/j.resuscitation.2006.09.006. Epub 2007 Jan 22.
citation: Kramer-Johansen J, Myklebust H, Wik L, Fellows B, Svensson L, Sorebo H, Steen PA. Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: a prospective interventional study. Resuscitation. 2006 Dec;71(3):283-92. doi: 10.1016/j.resuscitation.2006.05.011. Epub 2006 Oct 27.