Clinical trial NCT04085692: Dispatcher-Assisted CPR: Low-Dose, High-Frequency Simulation-Based Training
Official title: Dispatcher-Assisted Cardiopulmonary Resuscitation: A Randomized Controlled Trial of Low-Dose, High-Frequency Simulation-Based Training and the Impact on Real Out-of-Hospital Cardiac Arrest Calls
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Out-Of-Hospital Cardiac Arrest
Lead sponsor: Emergency Medical Services, Capital Region, Denmark
Sponsor class: OTHER_GOV
Collaborators: name: TrygFonden, Denmark
First posted: 2019-09-11
Enrollment: 52
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: After enrolment and consent from the EMDs, the EMDs will be randomly assigned to receive either LDHF simulation-based dispatcher training (intervention arm) or no LDHF simulation-based dispatcher training (comparison arm).

The EMDs will be randomly assigned to intervention or comparison group in a 1:1 ratio.

Randomisation will be stratified by the EMDs' medical backgrounds (paramedic, approximately 30% of the EMDs, or registered nurse, approximately 70% of the EMDs), to balance the number of EMDs with different medical backgrounds randomly assigned to each arm.
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Clear, concise, yes, and no answers can be challenging to achieve in the assessment of consciousness and breathing in out-of-hospital cardiac arrest (OHCA) calls. Often callers will provide an unclear response, and this can lead to hesitation on the part of the Emergency Medical Dispatcher (EMD). Further, the relatively small proportion OHCA calls represent might demand the need for simulation training in the dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) guiding itself. Therefore, the investigators investigate whether low-dose, high-frequency (LDHF) simulation-based training of EMDs can increase the quality of DA-CPR in a simulation setting. Additionally, the investigators measure whether the effect of the training will be transferred to real OHCA calls.

The study is a randomised controlled trial comparing LDHF simulation-based training to standard quality improvement of the EMD in a single centre. The study protocol is structured according to the SPIRIT 2013 statement, and the study will be reported in compliance with the CONSORT 2010 Statement. The investigators chose EMDs receiving standard quality improvement as the comparator group, to reflect a representative cohort of the EMDs not exposed to the LDHF simulation-based training program.

The aims of this study are:

1. To measure the effect of LDHF simulation-based training on the quality of DA-CPR in a simulation setting.
2. To measure the effect of LDHF simulation-based training on the quality of DA-CPR in real OHCA calls.

The investigators hypothesise that LDHF simulation-based training will increase the quality of DA-CPR in the intervention group in a simulation setting and that this improvement is transferred to real OHCA calls - although the effect in real OHCA calls might be smaller due to the complexity of some calls. The investigators hypothesise that this improvement can be detected as a decrease in time to first bystander compression (TTFC), an increase in clarification of consciousness and breathing without asking additional questions, a decrease in time to recognition of cardiac arrest, and an increase in calls where the EMD provide DA-CPR instructions on patients in cardiac arrest.


Eligibility criteria: Inclusion criteria:

- EMD employed at the Copenhagen EMS at the time of enrolment.

Exclusion criteria:

* Mean working time as call taker at Copenhagen EMS \< 8 hours/week.
* Planned employment cessation at the Copenhagen EMS during the data collection period.
* Planned leave from work longer than four weeks during the data collection period.
* Starting employment at the Copenhagen EMS during the study period.

Primary outcomes:
measure: Time from a call is taken by EMD to first bystander compression
timeFrame: During cardiac arrest calls, up to 1 hour
Secondary outcomes:
measure: EMD clarifies status of consciousness and breathing before asking any additional questions
timeFrame: During cardiac arrest calls, up to 1 hour
measure: Time from a call is taken by EMD to the recognition of cardiac arrest
timeFrame: During cardiac arrest calls, up to 1 hour
measure: EMD starts DA-CPR instructions
timeFrame: During cardiac arrest calls, up to 1 hour
measure: Time from a call is taken by EMD to EMD starts DA-CPR instructions
timeFrame: During cardiac arrest calls, up to 1 hour
measure: EMD is assertive when starting CPR instructions
timeFrame: During cardiac arrest calls, up to 1 hour
measure: EMD starts DA-CPR instructions on patient without cardiac arrest
timeFrame: During cardiac arrest calls, up to 1 hour
Other outcomes:
Locations:
city: Copenhagen
country: Denmark
facility: Copenhagen Emergency Medical Services
Study officials:
affiliation: Emergency Medical Services, Capital Region, Denmark
name: Freddy Lippert, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Emergency Medical Services, Capital Region, Denmark
name: Oscar Rosenkrantz
role: STUDY_DIRECTOR
References: