Clinical trial NCT05113706: Does Bystanders Emotional State Influence Dispatcher-assisted Cardiopulmonary?Resuscitation
Official title: Does Bystanders Emotional State Influence Dispatcher-assisted Cardiopulmonary Resuscitation?
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Out-Of-Hospital Cardiac Arrest
Emotional Distress
Keywords: Dispatcher
Emergency call
Out-Of-Hospital Cardiac Arrest
Lead sponsor: Emergency Medical Services, Capital Region, Denmark
Sponsor class: OTHER_GOV
First posted: 2021-11-09
Enrollment: 1100
Standard ages: CHILD
ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Bystander who call the emergency number in case of OHCA

Brief summary: The study aims to investigate bystanders' emotional stress state in out-of-hospital cardiac arrest (OHCA) emergency calls and the association with the quality of dispatcher-assisted cardiopulmonary resuscitation (DA-CPR).

Detailed description: Delayed CPR is believed to be an important factor in the outcome of out-of-hospital cardiac arrest (OHCA). Bystanders' emotional stress state might affect recognition of cardiac arrest and the resuscitation attempt. The study aims to investigate the association between a bystander's emotional stress state at the beginning of the emergency call in out-of-hospital cardiac arrest (OHCA) and dispatcher-assisted cardiopulmonary resuscitation (DA-CPR).

Method

The study is a retrospective and observational study of OHCA emergency calls from the capital region of Denmark from 01.09.2018 - 01.11.2019. The audio recordings of the emergency calls will be obtained from the emergency medical service database. A code catalogue with standardised default descriptions to each variable will be used. The study will only include the first person whom the medical dispatcher talk to. The rating of the calls will be performed by five observers outside of the research group, who have no conflict of interest.

The primary outcome of the present study will be to investigate an association between a bystander's emotional stress state in the beginning of the emergency call of OHCA and the time until first chest compression. Secondarily, the study investigated the association between the bystander's emotional stress and:

Outcome variables:

1. Time to recognition of OHCA, time to initiate CPR, and time to first compression.
2. Assessment of OHCA by the medical dispatcher (Does the dispatcher address patient breathing status and consciousness) (Yes/No)
3. The quality of DA-CPR instructions:

   1. Was the medical dispatcher motivating and encouraging when giving instructions (Yes/No)
   2. Was the medical dispatcher assertive or passive when giving instructions (Yes/No)
   3. Did the medical dispatcher instruct on depth and speed of compressions (Yes/No) Information about caller such as gender and relationship to the patient will also be included in the analyse.

Descriptive analysis of baseline characteristics of emergency calls and dispatchers will be performed by frequency distributions (N %) stratified by emotional stress.

Investigators will use logistic regression on categorical variables to analyse differences in the quality of DA-CPR based on the emotional stress state.

Wilcoxon rank-sum test will be used on non-normally distributed continuous variables to analyse differences in time until first chest compression. Two-way ANOVA will be used to analyse the mean of quantitative variables according to the levels of categorical variables. Furthermore, failure analysis was used to analyse and visualise differences in time until chest compressions based on the emotional stress state.

Kappa statistics were used to assess inter-rater variability and agreement between the reviewers. A Kappa score of overall agreement of 0.72% was found, which provides a substantial agreement between the raters.

Eligibility criteria: Inclusion Criteria:

* All emergency call recordings involving OHCA in the capital region of Denmark in the time period 01.09.2018 - 01.11.2019

Exclusion Criteria:

* Emergency medical services (EMS)-witnessed OHCA
* Missing emergency call recording
* Caller not physically by patient's site

Primary outcomes:
measure: Time to first compression
timeFrame: 0-15 minutes
Secondary outcomes:
measure: Time to to recognition of cardiac arrest
timeFrame: 0-15 minuts
measure: Dispatcher encouraging when giving instructions
timeFrame: 0-15 minuts
measure: Dispatcher assertive or passive when giving instructions
timeFrame: 0-15 minuts
measure: Dispatcher instruct on depth and speed of compressions
timeFrame: 0-15 minuts
Other outcomes:
Locations:
city: Copenhagen
country: Denmark
facility: Copenhagen Emergency Medical Services
state: Ballerup
Study officials:
affiliation: Copenhagen Emergency Medical Services
name: Gitte Linderoth, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Copenhagen Emergency Medical Services
name: Fredrik Folke, PhD, Prof
role: STUDY_CHAIR
affiliation: National Institute of Public Health, University of Southern Denmark
name: Annette Ersbøll, PhD, Prof
role: STUDY_CHAIR
References: