Arizona Prehospital CPR Quality Improvement Project

Study Description

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Brief Summary:

The quality of cardiopulmonary resuscitation (CPR) provided to patients with out-of-hospital cardiac arrest (OHCA) is often suboptimal. There now exist monitors/defibrillators that allow for the measurement and real time feedback of the quality of chest compressions and ventilations. In addition to giving the prehospital provider the benefit of real time CPR quality feedback via voice and visual cues, the CPR quality data acquired using these devices can be utilized as part of an on-going quality assurance/quality improvement program.

The first objective of the proposed project is to quantify the quality of chest compressions and ventilations provided in the state of Arizona to patients with OHCA and to determine whether the quality of CPR is related to patient outcome from OHCA.

A second objective of this project is to determine whether use of audiovisual feedback improves both CPR quality and patient outcome in the pre-hospital setting.

Condition or disease	Intervention/treatment
Out-of-Hospital Cardiac Arrest	Other: Audiovisual Feedback

Detailed Description:

Phase I: In the first phase of the project, the EMS systems will utilize the E-series units to treat all patients with OHCA. The audiovisual feedback prompts will be inactivated during this phase. The EMS providers will be instructed to follow the standard CCR protocol, as is currently the practice. Aside from the change in monitor/defibrillator equipment, the treatment of OHCA patients during this phase will be identical to the treatment that is currently performed. The quality of CPR will be measured using the accelerometer-based system. The data will be stored in the defibrillator and will be downloaded upon completion of the call. The first phase will be conducted for approximately 6 months from the time each site initiates the use of the E-series monitor/defibrillators.

Phase 2:In the second phase of the project, the EMS providers will undergo training on how to use the audiovisual feedback prompts. The providers will continue to treat patients according to the CCR protocol but will now receive audio and/or visual feedback on the quality of CPR that they are performing. The providers will select the preferred feedback method(s) - audio, visual or both. As in phase I, the CPR data will be stored in the defibrillator and will be downloaded upon completion of the call.

The total number of EMS personnel who will be trained is approximately 450. In Phase I, there were 219 OHCAs (80% from Mesa Fire Dept, and 20% from Guardian Medical Transport). So far in Phase II, there have been about 100 OHCAs.

Study Design

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Study Type :	Observational
Actual Enrollment :	101 participants
Observational Model:	Other
Time Perspective:	Prospective
Official Title:	Arizona Prehospital CPR Quality Improvement Project
Actual Study Start Date :	December 7, 2010
Actual Primary Completion Date :	February 25, 2015
Actual Study Completion Date :	February 25, 2015

Groups and Cohorts

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Group/Cohort	Intervention/treatment
Audiovisual feedback on CPR; EMS technicians will receive audiovisual feedback from the ZOLL device on depth, frequency, and interruptions to cardiac compressions	Other: Audiovisual Feedback; EMTs will get audiovisual feedback on CPR technique during CPR

Outcome Measures

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Primary Outcome Measures :

1. Quality of chest compressions [ Time Frame: Phase I - 6 months; Phase II - 20 months ]
   Depth of chest compressions, rate of chest compressions, and interruptions in chest compressions

Secondary Outcome Measures :

1. Survival to hospital discharge [ Time Frame: Phase I - 6 months; Phase II - 20 months ]
   Did the patient survive to hospital discharge? (Yes or no--dichotomous measure)

Eligibility Criteria

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Ages Eligible for Study:	24 Years to 55 Years (Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	Yes
Sampling Method:	Non-Probability Sample

Study Population

Emergency medical services providers in 4 different Arizona cities

Criteria

Inclusion Criteria:

• Emergency Medical Services personnel at 8 fire departments in AZ who treat patients with out of hospital cardiac arrest (OHCA)

Exclusion Criteria:

Contacts and Locations

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Locations

United States, Arizona
Guardian Medical Transport
Flagstaff, Arizona, United States, 86001
Mesa Fire Department
Mesa, Arizona, United States, 85201

Sponsors and Collaborators

Maricopa Integrated Health System

Arizona Department of Health Services

Guardian Medical Transport

Mesa Fire Department

Zoll Medical Corporation

Investigators

Principal Investigator:	Bentley J Bobrow, MD	Arizona Department of Health Services, Maricopa Integrated Health System

More Information

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Publications:

Bobrow BJ, Clark LL, Ewy GA, Chikani V, Sanders AB, Berg RA, Richman PB, Kern KB. Minimally interrupted cardiac resuscitation by emergency medical services for out-of-hospital cardiac arrest. JAMA. 2008 Mar 12;299(10):1158-65. doi: 10.1001/jama.299.10.1158.

Handley AJ, Handley SA. Improving CPR performance using an audible feedback system suitable for incorporation into an automated external defibrillator. Resuscitation. 2003 Apr;57(1):57-62.

Responsible Party:	Maricopa Integrated Health System
ClinicalTrials.gov Identifier:	NCT01258244 History of Changes
Other Study ID Numbers:	2010-118
First Posted:	December 10, 2010
Last Update Posted:	January 25, 2018
Last Verified:	January 2018

Keywords provided by Maricopa Integrated Health System:

Out-of-Hospital Cardiac Arrest, OHCA

Additional relevant MeSH terms:

Heart Arrest; Out-of-Hospital Cardiac Arrest; Heart Diseases; Cardiovascular Diseases