An observational study in Cardiac Arrest, sponsored by Ottawa Hospital Research Institute. Completed at 1 site in Canada. Open to participants aged 16 Years and older. Per ClinicalTrials.gov, last updated 2021-03-17.
Sponsored by Ottawa Hospital Research Institute · Observational
The main goal of this project is to help 9-1-1 emergency medical dispatchers save the lives of more cardiac arrest victims. The investigators will develop teaching tools to help the dispatchers recognize abnormal breathing that may indicate a victim as having a cardiac arrest. After training sessions, the investigators will see if dispatchers can get better at recognizing abnormal breathing, how often they give CPR instructions, and if use of the teaching tool will increase bystander CPR and the number of victims leaving the hospital alive.
Cardiac arrest is a leading cause of death in Canada; it is defined as the sudden cessation of cardiac mechanical activity. It is uniformly fatal if not treated within minutes. More than 85% of out-of-hospital cardiac arrest (OOHCA) occur in residential locations so public access to automatic external defibrillators, to restart the heart, are not helpful. The overall rate of survival for OOHCA rarely exceeds 8%.
Bystander cardiopulmonary resuscitation (CPR) is chest compression and ventilations provided by someone not on the emergency response team. A victim or cardiac arrest is almost 4 times more likely to survive when receiving bystander CPR. However, despite various attempts to improve bystander rates they have remained low, not exceeding 15% in Ontario. It has been shown that since the ambulance dispatch centres in Ontario implemented dispatch-assisted CPR instructions (given to callers while emergency vehicles were on the way), there was a significant increase in use.
Emergency medical dispatchers can identify about 70% of OOHCA cases over the phone. Agonal breathing (laboured breathing preceding death) may be misinterpreted as a sign of life, and is responsible for as much as 50% of missed diagnoses. There is no specific training on the significance of this sign, and minimal information about recognizing cardiac arrest. An educational intervention designed to better understand the significance of agonal breathing and to clarify the existing CPR instruction protocol will most likely increase the frequency of CPR instructions, bystander CPR rates, and potentially survival of victims of cardiac arrest.
966 studies on the registry are indexed under Heart Arrest; 226 are open to participants now.
This study's enrollment of 1,076 is above the median of 200 across 382 observational studies indexed under Heart Arrest.
Browse Heart Arrest studies →Ottawa Hospital Research Institute is the lead sponsor of 538 studies on the registry; 100 are open to participants now.
Counted across the registry records on this site, refreshed daily.
All patients with out-of-hospital cardiac arrest
Exclusion Criteria:
All emergency medical dispatchers at a central ambulance communication centre in Ontario will participate in an educational program designed to improve cardiac arrest diagnostic accuracy.
Behavioral: Education
All emergency medical dispatchers at a central ambulance communications centre geographically remote from the Training Site and has a similar rate to the Training Site for cardiac arrests, bystander CPR rate, and survival
An education program will be developed using behaviour change techniques specifically mapped to address modifiable factors identified in a previous study. These techniques will include: information about the significance of agonal breathing, modeling/demonstration of desired behavioural skills, rehearsal of desired skills, and monitoring/reinforcement and feedback.
Number of Participants With Agonal Breathing
By reviewing recordings of all cardiac arrest calls, including missed cases retrieved from a registry, document presence or absence of agonal breathing.
Time frame: At the time of the cardiac arrest event
Number of Cases Where Cardiac Arrest Was Recognized by the Ambulance Dispatcher
By reviewing recordings of all cardiac arrest calls, collect information on dispatcher recognition of cardiac arrest to bystander implementation of chest compressions
Time frame: At the time of the cardiac arrest event
Number of Participants Who Received Bystander CPR
The first member of the emergency response team to arrive at scene will document whether or not chest compressions have been initiated by someone prior to the arrival of emergency team
Time frame: At the time of the cardiac arrest event
Number of Participants Surviving to Hospital Discharge
Accessing hospital medical records or coroner's reports, assess survival of cardiac arrest victim as being discharged alive from hospital
Time frame: At the time of the cardiac arrest event to discharge alive from hospital (varies, depending on length of hospital stay)
| Milestone | Training Site | Control Site |
|---|---|---|
| Started | 689 | 387 |
| Completed | 689 | 387 |
| Not completed | 0 | 0 |
By reviewing recordings of all cardiac arrest calls, including missed cases retrieved from a registry, document presence or absence of agonal breathing.
| Participants | Training Site | Control Site |
|---|---|---|
| Number of Participants With Agonal Breathing | 176 | 87 |
By reviewing recordings of all cardiac arrest calls, collect information on dispatcher recognition of cardiac arrest to bystander implementation of chest compressions
| Participants | Training Site | Control Site |
|---|---|---|
| Number of Cases Where Cardiac Arrest Was Recognized by the Ambulance Dispatcher | 495 | 287 |
The first member of the emergency response team to arrive at scene will document whether or not chest compressions have been initiated by someone prior to the arrival of emergency team
| Participants | Training Site | Control Site |
|---|---|---|
| Number of Participants Who Received Bystander CPR | 247 | 153 |
Accessing hospital medical records or coroner's reports, assess survival of cardiac arrest victim as being discharged alive from hospital
| Participants | Training Site | Control Site |
|---|---|---|
| Number of Participants Surviving to Hospital Discharge | 86 | 27 |
Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Training Site | — | 0/689 (0%) | 0/689 (0%) |
| Control Site | — | 0/387 (0%) | 0/387 (0%) |
| Age, Continuous(years) | Training Site | Control Site | Total |
|---|---|---|---|
| Mean | 68 (16 to 100) | 68 (22 to 98) | 68 (16 to 100) |
| Sex: Female, Male(Participants) | Training Site | Control Site | Total |
|---|---|---|---|
| Female | 217 | 136 | 353 |
| Male | 472 | 251 | 723 |
| Race and Ethnicity Not Collected(Participants) | Training Site | Control Site | Total |
|---|---|---|---|
| Count of participants | — | — | 0 |
| Region of Enrollment(participants) | Training Site | Control Site | Total |
|---|---|---|---|
| Canada | 689 | 387 | 1076 |
| Witnessed Status(Participants) | Training Site | Control Site | Total |
|---|---|---|---|
| Count of participants | 310 | 162 | 472 |
| Initial Cardiac Rhythm Ventricular Fibrillation/Ventricular Tachycardia(Participants) | Training Site | Control Site | Total |
|---|---|---|---|
| Count of participants | 199 | 87 | 286 |
This study is completed, as verified in Feb 2021. You cannot join it, but the record below documents what was studied.
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Ottawa Hospital Research Institute