Clinical trial NCT00219687: Dispatcher-Assisted Resuscitation Trial (DART)
Official title: Randomized Trial of Dispatcher-Assisted CPR:Chest Compression Alone Versus Chest Compression Plus Ventilation
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE3
Conditions: Heart Arrest
Keywords: Heart arrest
Cardiopulmonary resuscitation
Dispatcher
Lead sponsor: Public Health - Seattle and King County
Sponsor class: OTHER_GOV
First posted: 2005-09-22
Enrollment: 5494
Sex: ALL
Minimum age (years): 9
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to determine whether dispatcher-assisted CPR instructions with compressions and ventilations versus dispatcher-assisted CPR instructions with compressions only improves survival from out-of-hospital cardiac arrests.

Detailed description: Out-of-hospital cardiac arrest, a condition characterized by a person suddenly collapsing due to heart stoppage, is a leading cause of death in the United States. In out-of-hospital cardiac arrest, survival is dependent upon what the American Heart Association has termed the chain of survival which includes quick activation of the 9-1-1 system, prompt cardiopulmonary resuscitation (CPR), early defibrillation, and qualified advanced life support care (paramedic care). CPR allows for some circulation and delivery of oxygen to vital organs when the heart is no longer beating on its own. However, in some instances, the citizen bystander has not been trained in CPR, presenting a circumstance where the cardiac arrest victim may not receive CPR until the arrival of emergency medical services (EMS) personnel (i.e., paramedics). The delay in CPR adversely affects outcome and dcreases the chance of survival. In response to this need, the EMS Division of Public Health - Seattle and King County developed and instituted telephone CPR instructions that could be provided "on-the-spot" during a cardiac arrest by the emergency medical (9-1-1) dispatcher. The instructions are designed to be given over the phone to persons who have not had previous CPR training so that they can initiate CPR prior to the arrival of EMS personnel and have been termed "dispatcher-assisted" CPR. The dispatcher instructions provided by the dispatch agencies of King County include the standard "full" CPR protocol of ventilations (breathing into the victim's mouth to inflate the lungs) and chest compressions(pumping on the patients chest to help circulate the blood). The ventilations oxygenate the blood while the chest compressions pump the oxygenated blood forward. This EMS program has led to a considerable increase in the proportion of cardiac arrest victims in King County that receive citizen bystander CPR prior to EMS arrival and has been associated with improved survival (appendix 1).

Comparison: Dispatcher-assisted CPR instructions with compressions and ventillations compared to dispatcher-assisted CPR instructions with compressions only.

Eligibility criteria: Inclusion Criteria:

* Cardiac arrest events where CPR is not ongoing but a bystander is willing to attempt with assistance

Exclusion Criteria:

* Pregnancy
* Prisoners
* Cardiac arrest due to asphyxia, drowning, hanging, or electrocution

Primary outcomes:
measure: Survival to hospital discharge
timeFrame: varied
Secondary outcomes:
measure: Neurological status at hospital discharge
timeFrame: varied
Other outcomes:
Locations:
city: Olympia
country: United States
facility: Thurston County Dispatch
state: Washington
city: Seattle
country: United States
facility: Division of Emergency Medical Services, Public Health - Seattle and King County
state: Washington
city: London
country: United Kingdom
facility: London Ambulance Service
state: England
Study officials:
affiliation: Division of Emergency Medical Services, Public Health - Seattle and King County
name: Thomas D Rea, MD, MPH
role: PRINCIPAL_INVESTIGATOR
affiliation: Division of Emergency Medical Services, Public Health - Seattle and King County
name: Mickey S Eisenberg, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Rea TD, Fahrenbruch C, Culley L, Donohoe RT, Hambly C, Innes J, Bloomingdale M, Subido C, Romines S, Eisenberg MS. CPR with chest compression alone or with rescue breathing. N Engl J Med. 2010 Jul 29;363(5):423-33. doi: 10.1056/NEJMoa0908993.