Basic Life Support Termination of Resuscitation Implementation Study

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00370461
Recruitment Status : Completed
First Posted : August 31, 2006
Last Update Posted : November 17, 2015
Information provided by (Responsible Party):
Dr. Laurie Morrison, Sunnybrook Health Sciences Centre

Brief Summary:

In Ontario, most people who experience a cardiac arrest at home (when their heart stops beating) only receive basic life support from Primary Care Paramedics (PCPs) and all are transported to the hospital. Most are pronounced dead by the emergency physician as the mean survival rate for these patients is 5%. Allowing Primary Care Paramedics to use a termination of resuscitation guideline would identify futile cases for which further resuscitation is unwarranted and decrease the number of patients being transported to the emergency department (ED) for pronouncement.

There are numerous advantages to this strategy; first, it may improve the efficiency of the ED because cardiac arrest patients require immediate attention that is diverted from patients who have a better chance at survival. Second, the risk of injury and the monetary costs for the paramedic and the public would be minimized with fewer "light and sirens" transports which are known to be hazardous to motorists, pedestrians, and Emergency Medical Services (EMS) personnel.

For each cardiac arrest, PCPs will respond to the call as usual and implement standard basic life support cardiac arrest protocols. Patients are then categorized according to the termination of resuscitation recommendations:

  1. no return of spontaneous circulation is achieved (no heartbeat);
  2. no shock was given prior to transport; and
  3. the arrest (when the heart stops beating) was not witnessed by EMS personnel.

If all of these criteria are true, the PCP will contact the hospital and the decision by the emergency physician will then be made to stop life saving measures (terminate resuscitation) in the home or continue with life support and transport the patient to the local emergency department.

This study aims to document the usefulness of the termination of the resuscitation guideline in decreasing the rate of transport of out-of-hospital cardiac arrest patients to the ED. Secondary aims of this implementation study will be to describe the rates of erroneous application of the guideline. The comfort of use of the rule among paramedics and base hospital emergency physicians will be described.

Condition or disease
Cardiac Arrest

  Show Detailed Description

Study Type : Observational
Actual Enrollment : 350 participants
Observational Model: Case-Only
Time Perspective: Prospective
Official Title: Basic Life Support Termination of Resuscitation in the Prehospital Environment for Primary Care Paramedics - A Prospective Observational Study of the Implementation of a Clinical Prediction Rule
Study Start Date : January 2006
Actual Primary Completion Date : December 2010
Actual Study Completion Date : June 2012

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Cardiac Arrest
U.S. FDA Resources

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population
This is a multi centre prospective observational study of the implementatiaon of a Basic Life Support Termination of Resuscitation(BLS TOR)guideline.The study will accrue all out of hospital cardiac arrest cases from 9 regions across the province of Ontario(Cornwall, Hamilton,Peel, Peterborough, Grey Bruce Huron, Timmins, Sault Ste Marie, Simcoe/Muskoka, Cambridge). There are 22 participating EMS systems over the 9 regions.

Inclusion Criteria:

  • Age > 18
  • No advanced cardiac life support procedures (ACLS) were available during the call
  • The cardiac arrest is of presumed cardiac cause only

Exclusion Criteria:

  • Age < 18
  • The patient possesses a documented do-not-resuscitate (DNR) order
  • The cardiac arrest is due to non cardiac causes such as trauma, drowning or drug overdose
  • Patient receives any prehospital ACLS care

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00370461

Canada, Ontario
Royal Victoria Hospital
Barrie, Ontario, Canada, L4N 1K4
Cornwall Community Hospital
Cornwall, Ontario, Canada, K6H 1Z6
Hamilton Health Sciences
Hamilton, Ontario, Canada, L8V 1C3
Grey Bruce Huron
Owen Sound, Ontario, Canada, N4K 6M9
Peterborough Regional Health Center
Peterborough, Ontario, Canada, K9J 7C6
Sault Area Hospital
Sault Ste Marie, Ontario, Canada, P6A 2C4
Timmins and District Hospital
Timmins, Ontario, Canada, P4N 8P2
Sponsors and Collaborators
Sunnybrook Health Sciences Centre
Principal Investigator: Laurie J Morrison, MD Rescu, St. Michael's Hospital Toronto
Principal Investigator: Richard P Verbeek, MD Division of Emergency Medicine, Department of Medicine, University of Toronto and Sunnybrook Osler Center for Prehospital Care
Principal Investigator: Don Eby, MD Grey Bruce Huron Paramedic Base Hospital Program, Grey Bruce Health Services, Owen Sound Hospital

Responsible Party: Dr. Laurie Morrison, Clinician Scientist, Sunnybrook Health Sciences Centre Identifier: NCT00370461     History of Changes
Other Study ID Numbers: MOP67110
First Posted: August 31, 2006    Key Record Dates
Last Update Posted: November 17, 2015
Last Verified: November 2015

Keywords provided by Dr. Laurie Morrison, Sunnybrook Health Sciences Centre:
Basic Cardiac Life Support
Termination of Resuscitation
Emergency Medical Services
Primary Care Paramedics
Out of Hospital Cardiac Arrest

Additional relevant MeSH terms:
Heart Arrest
Heart Diseases
Cardiovascular Diseases