Information obtained from ClinicalTrials.gov on May 16, 2013 Link to the current ClinicalTrials.gov record. http://clinicaltrials.gov/show/NCT00998140 NIHPR 08/90/a NCT00998140 Optimizing Resuscitation After Cardiac Arrest in the Community Optimizing Resuscitation After Cardiac Arrest in the Community: Increasing the Probability of Survival While Reducing Costs Shaare Zedek Medical Center Other Shaare Zedek Medical Center Israel: Ministry of Health No Resuscitative efforts have been shown to be unsuccessful in most cases of out-of-hospital cardiac arrest (OHCA), and survivors who do recover cardiac function often sustain severe hypoxic brain damage. Time to efficacious care is a primary determinant of disability-free survival. In the Jerusalem district, only 9% of OHCA patients present with ventricular tachycardia/ventricular fibrillation (VT/VF) as the primary rhythm, whereas 77% present with asystole; this seems primarily to be the result of long collapse-to-arrival times. Nevertheless, overly zealous resuscitation is undertaken in a high proportion of arrests with a futile prognosis, leading to excessive costs. Study hypotheses: 1. Subpopulations for whom intervention is futile/counter-productive are identifiable 2. Substantial waste of resources can be avoided 3. Optimization of emergency medical services (EMS) reorganization without adding resources is an achievable goal Recruiting March 2009 March 2012 N/A Observational Observational Model: Cohort 1 1600 Cardiopulmonary Arrest Outcome All victims of non-traumatic out-of hospital cardiopulmonary arrest (defined as the absence of either spontaneous respiration or palpable pulse or both) within the Jerusalem district. Probability Sample Inclusion Criteria: - All victims of non-traumatic out-of hospital cardiopulmonary arrest (defined as the absence of either spontaneous respiration or palpable pulse or both) within the Jerusalem district. Exclusion Criteria: - Patients with do-not-resuscitate orders or an advance directive to that effect. Both 18 Years N/A No Sharon Einav, MD Principal Investigator Shaare Zedek Medical Center Sharon Einav, MD 972-508-685-480 einav_s@szmc.org.il Nechama Kaufman, MN 972-508-685-324 kaufman_n@hotmail.com Shaare Zedek Medical Center

Jerusalem Israel

Recruiting Sharon Einav, MD Principal Investigator Israel May 2011 May 17, 2011 October 18, 2009 Sharon Einav, MD, Director of Surgical ICU Shaare Zedek Medical Center resuscitation sudden death cardiopulmonary resuscitation emergency medical services termination of resuscitation ventricular fibrillation out-of-hospital cardiac arrest asystole medical futility withdrawing treatment transportation of patients health expenditures healthcare costs No No Heart Arrest