The Effect of T-CPR on the Quality of CPR and AED Use

Overview

The purpose of the study is to examine the effect of telephone assistance and standardized basic life support courses on the quality of cardiopulmonary resuscitation (CPR) and the use of automated external defibrillator (AED). The investigators hypothesize that bystanders can provide compressions in correct frequency and use an AED correctly as well as safely from telephone instructions but that correct and successful ventilations including correct open airway require training on a course.

Full Title of Study: “The Effect of Telephone Assistance on the Quality of Cardiopulmonary Resuscitation and Use of Automated External Defibrillator.”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Other
    • Masking: None (Open Label)
  • Study Primary Completion Date: August 23, 2020

Detailed Description

The study aims at answering the following research questions: 1. How is the quality of CPR and use of AED when performed by an inexperienced bystander who receives telephone assistance compared to the quality when performed by a trained bystander, who has passed a standardized European Resuscitation Council (ERC) course in basic life support (BLS) but does not receive telephone assistance? 2. How is the quality of CPR and use of AED when performed by a trained bystander who has passed a standardized ERC course in BLS and who receives telephone assistance compared to the quality when performed by a trained bystander who does not receive telephone assistance? The questions are sought answered through simulated cardiac arrest scenarios in non-classroom settings. Participants are recruited from ERC courses in BLS. Participants are randomised to one of three groups (stratified for course type using computer-generated randomisation lists with blocks of variable sizes): 1. Cardiac arrest scenario test before BLS course with telephone-assistance. 2. Cardiac arrest scenario test after BLS course, no telephone-assistance. 3. Cardiac arrest scenario test after BLS course with telephone-assistance.

Interventions

  • Other: T-CPR
    • Participants receive telephone instructions in cardiopulmonary resuscitation (T-CPR) from the Emergency Medical Services in Copenhagen during the cardiac arrest scenario test.
  • Other: ERC standardized BLS course
    • Participants will receive and complete the standardized course in basic life support (BLS) from European Resuscitation Council (ERC).

Arms, Groups and Cohorts

  • Experimental: No BLS course. With T-CPR.
    • The participant is presented for a cardiac arrest scenario before attending the ERC standardized BLS course. During the scenario test, the participant will receive T-CPR.
  • Experimental: With BLS course. No T-CPR.
    • The participant is presented for a cardiac arrest scenario after completion of the ERC standardized BLS course. During the scenario test, the participant will not receive T-CPR.
  • Experimental: With BLS course. With T-CPR.
    • The participant is presented for a cardiac arrest scenario after completion of the ERC standardized BLS course. During the scenario test, the participant will receive T-CPR.

Clinical Trial Outcome Measures

Primary Measures

  • Compression depth
    • Time Frame: 8 minutes
    • Keeps a compression depth as recommended by International Liaison Committee on Resuscitation (ILCOR) (5-6 cm) on at least 50 % of compressions (yes/no). Measured by advanced manikin.
  • Compression rate
    • Time Frame: 8 minutes
    • Rescuer keeps a compression rate of approximately 100-120 compressions per min. throughout the CPR (yes/no). Measured by advanced manikin.
  • Shock delivered
    • Time Frame: 8 minutes
    • Shock delivered with AED (yes/no). Assessed by ERC instructor.

Secondary Measures

  • Hands-of time
    • Time Frame: 8 minutes
    • Relevant actions of resuscitation within more than 75 % of the test time (yes/no). Measured as no flow time by advanced manikin.
  • Responsiveness
    • Time Frame: 8 minutes
    • Shakes AND shouts (yes/no). Assessed by ERC instructor.
  • Open airway
    • Time Frame: 8 minutes
    • Opens or correctly tries to open mouth (chin lift OR jaw thrust) (yes/no). Assessed by ERC instructor.
  • Assess breathing
    • Time Frame: 8 minutes
    • Looks, listens AND feels for normal breathing (yes/no). Assessed by ERC instructor.
  • Recoil/lean
    • Time Frame: 8 minutes
    • Full rise on at least 50 % of all compressions (yes/no). Measured by advanced manikin.
  • Rescue breaths
    • Time Frame: 8 minutes
    • More than 400 mL for at least 50 % of all ventilations (yes/no). Measured by advanced manikin.
  • Ratio
    • Time Frame: 8 minutes
    • Acceptable range 28-32:2 (yes/no). Assessed by ERC instructor.
  • Activate AED
    • Time Frame: 8 minutes
    • Activates AED immediately upon arrival (yes/no). Assessed by ERC instructor.
  • Attachment of AED pads
    • Time Frame: 8 minutes
    • Correct attachment of AED pads according to the picture in protocol (yes/no). Assessed by ERC instructor.
  • Stand clear
    • Time Frame: 8 minutes
    • Ensures safety by looking around and verbally announcing delivery of shock (yes/no). Assessed by ERC instructor.
  • Compression depth 2
    • Time Frame: 8 minutes
    • Percentage of compressions with a depth within the recommendations from ILCOR (5-6 cm) (%). Measured by advanced manikin.
  • Compression rate 2
    • Time Frame: 8 minutes
    • Average rate of compressions (compressions/minute). Measured by advanced manikin.
  • Rescue breaths 2
    • Time Frame: 8 minutes
    • Percentage of ventilations with more than 400 mL (%). Measured by advanced manikin.
  • Time to first compression
    • Time Frame: 8 minutes
    • Time from scenario start to first compression. Assessed by ERC instructor.
  • Hand placement
    • Time Frame: 8 minutes
    • Correct hand placement in at least 50 % of compressions (yes/no). Measured by advanced manikin.

Participating in This Clinical Trial

Inclusion Criteria

  • Participant at a European Resuscitation Council standardized basic life support course. Participants are enrolled from courses for university students, courses for elderly and courses for recruits in the Danish Emergency Management Agency. Exclusion Criteria:

  • Basic life support course within the last two years. – Healthcare professional or background as healthcare professional. – Instructor in basic life support or first aid. – Lifeguard or background as lifeguard. – Does not want to participate.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Copenhagen Academy for Medical Education and Simulation
  • Collaborator
    • TrygFonden, Denmark
  • Provider of Information About this Clinical Study
    • Principal Investigator: Kristine Elisabeth Eberhard, Researcher, medical student – Copenhagen Academy for Medical Education and Simulation
  • Overall Official(s)
    • Freddy Lippert, Study Director, Emergency Medical Services, Capital Region, Denmark
    • Doris Oestergaard, Study Director, Copenhagen Academy for Medical Education and Simulation

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