Trial Outcomes & Findings for Effects of a New Dispatcher-Assisted Basic Life Support Training Program (NCT NCT02142387)

Last Updated: 2020-05-01

Results Overview

The study end points are survival to hospital discharge. Survival to discharge will be measured as proportions of patients who were discharged from a hospital with their spontaneous circulation recovered. This information will be collected from medical record review.

Recruitment status

COMPLETED

Study phase

Target enrollment

18822 participants

Primary outcome timeframe

from date of discharge, assessed up to 3 months

Results posted on

2020-05-01

Participant Flow

Participant milestones

Participant milestones
Measure	New DA-BLS Training Program A one-hour training course that includes a 30-minute video-based self-instruction (VSI) training session, a short role-play, and a debriefing. The video consists of a bystander CPR simulation with dispatcher instructions using the trainee's own phone and practice session following demonstration by a simulated layperson. After watching the video clip, all trainees are divided into two groups and conduct a role-play as dispatchers and laypersons for 15 minutes. Finally, there is a 15-minute debriefing session with several assignments. The program focuses on cooperation with a dispatcher, from recognition of cardiac arrest to performing DA-CPR, with hands-on practice so that laypersons can provide bystander CPR immediately in a real situation.	Current Basic Life Support (BLS) Training Program A one-hour training program that was developed by the Korea Center for Disease and Prevention (CDC) and it was based on the American Heart Association (AHA) guideline (http://www.cdc.go.kr/board.es?mid=a20503050000\&bid=0021\&tag=\&act=view\&list\_no=127655). The program consists of a 30-minute VSI, and a 30-minute practice debriefing session. It focuses on detailed techniques for performing high-quality chest compressions including the correct hands and body position of the bystanders.
Overall Study STARTED	2551	16271
Overall Study COMPLETED	1486	8641
Overall Study NOT COMPLETED	1065	7630

Reasons for withdrawal

Reasons for withdrawal
Measure	New DA-BLS Training Program A one-hour training course that includes a 30-minute video-based self-instruction (VSI) training session, a short role-play, and a debriefing. The video consists of a bystander CPR simulation with dispatcher instructions using the trainee's own phone and practice session following demonstration by a simulated layperson. After watching the video clip, all trainees are divided into two groups and conduct a role-play as dispatchers and laypersons for 15 minutes. Finally, there is a 15-minute debriefing session with several assignments. The program focuses on cooperation with a dispatcher, from recognition of cardiac arrest to performing DA-CPR, with hands-on practice so that laypersons can provide bystander CPR immediately in a real situation.	Current Basic Life Support (BLS) Training Program A one-hour training program that was developed by the Korea Center for Disease and Prevention (CDC) and it was based on the American Heart Association (AHA) guideline (http://www.cdc.go.kr/board.es?mid=a20503050000\&bid=0021\&tag=\&act=view\&list\_no=127655). The program consists of a 30-minute VSI, and a 30-minute practice debriefing session. It focuses on detailed techniques for performing high-quality chest compressions including the correct hands and body position of the bystanders.
Overall Study <19 years old	49	326
Overall Study non-cardiac etiology	504	3431
Overall Study CPR not performed	74	473
Overall Study witnessed by paramedic	139	917
Overall Study incomplete data	1	9
Overall Study occurred not at home	298	2474

Baseline Characteristics

Effects of a New Dispatcher-Assisted Basic Life Support Training Program

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	Districts Which Implement New DA-BLS Training Program n=1486 Participants A one-hour training course that includes a 30-minute video-based self-instruction (VSI) training session, a short role-play, and a debriefing. The video consists of a bystander CPR simulation with dispatcher instructions using the trainee's own phone and practice session following demonstration by a simulated layperson. After watching the video clip, all trainees are divided into two groups and conduct a role-play as dispatchers and laypersons for 15 minutes. Finally, there is a 15-minute debriefing session with several assignments. The HEROS program focuses on cooperation with a dispatcher, from recognition of cardiac arrest to performing DA-CPR, with hands-on practice so that laypersons can provide bystander CPR immediately in a real situation. Moreover, the HEROS program emphasizes practice for providing the correct address of the scene and switching to speakerphone mode, especially for the elderly.	Districts Which Keep Current BLS Training Program n=8641 Participants A one-hour training program that was developed by the Korea CDC and it was based on the AHA guideline (http://www.cdc.go.kr/board.es?mid=a20503050000\&bid=0021\&tag=\&act=view\&list\_no=127655). The program consists of a 30-minute VSI, and a 30-minute practice debriefing session. It focuses on detailed techniques for performing high-quality chest compressions including the correct hands and body position of the bystanders.	Total n=10127 Participants Total of all reporting groups
Age, Continuous	74 years n=5 Participants	74 years n=7 Participants	74 years n=5 Participants
Sex: Female, Male Female	623 Participants n=5 Participants	3487 Participants n=7 Participants	4110 Participants n=5 Participants
Sex: Female, Male Male	863 Participants n=5 Participants	5154 Participants n=7 Participants	6017 Participants n=5 Participants
Race (NIH/OMB) American Indian or Alaska Native	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) Asian	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) Black or African American	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) White	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) More than one race	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) Unknown or Not Reported	1486 Participants n=5 Participants	8641 Participants n=7 Participants	10127 Participants n=5 Participants
witnessed by laypersons	681 Participants n=5 Participants	3993 Participants n=7 Participants	4674 Participants n=5 Participants
DA-CPR	1139 Participants n=5 Participants	6717 Participants n=7 Participants	7856 Participants n=5 Participants
bystander CPR	859 Participants n=5 Participants	5281 Participants n=7 Participants	6140 Participants n=5 Participants
shockable rhythm	187 Participants n=5 Participants	1080 Participants n=7 Participants	1267 Participants n=5 Participants
level of ED Level 1	12 Participants n=5 Participants	1086 Participants n=7 Participants	1098 Participants n=5 Participants
level of ED Level 2	1276 Participants n=5 Participants	6533 Participants n=7 Participants	7809 Participants n=5 Participants
level of ED Level 3	198 Participants n=5 Participants	1022 Participants n=7 Participants	1220 Participants n=5 Participants

PRIMARY outcome

Timeframe: from date of discharge, assessed up to 3 months

Outcome measures

Outcome measures
Measure	Districts Which Implement Newer DA-BLS Training Program n=1486 Participants the out of hospital cardiac arrest victims who were given bystander CPR by whom trained as newer dispatcher-assisted BLS training program, which more focuses on cooperation with a dispatcher, from recognition to perform DA-CPR and hands-on practice. BLS CPR program with dispatcher assisted CPR simulation: the training program more focuses on cooperation with a dispatcher, from recognition to perform DA-CPR and hands-on practice.	Districts Which Keep Traditional BLS Training Program n=8641 Participants Control group commonly uses a one-hour training program which was developed by the Korea CDC. It focuses on detailed techniques of performing high-quality chest compressions.
Number of Participants Surviving to Hospital Discharge	85 Participants	551 Participants

SECONDARY outcome

Timeframe: from date of cardiac arrest occurred, assessed up to 1 week

The return of spontaneous circulation will be measured as proportion of the patients who were recovered their circulation at emergency department. This information will be collected from the medical review.

Outcome measures

Outcome measures
Measure	Districts Which Implement Newer DA-BLS Training Program n=1486 Participants the out of hospital cardiac arrest victims who were given bystander CPR by whom trained as newer dispatcher-assisted BLS training program, which more focuses on cooperation with a dispatcher, from recognition to perform DA-CPR and hands-on practice. BLS CPR program with dispatcher assisted CPR simulation: the training program more focuses on cooperation with a dispatcher, from recognition to perform DA-CPR and hands-on practice.	Districts Which Keep Traditional BLS Training Program n=8641 Participants Control group commonly uses a one-hour training program which was developed by the Korea CDC. It focuses on detailed techniques of performing high-quality chest compressions.
Number of Participants With Return of Spontaneous Circulation (ROSC)	544 Participants	3118 Participants

SECONDARY outcome

Timeframe: from date of discharge, assessed up to 3 months

The Cerebral Performance Categories (CPC) score will be used to measure neurological recovery status: CPC 1 (good cerebral performance), CPC 2 (moderate cerebral disability), CPC 3 (severe cerebral disability), CPC 4 (coma or vegetative state), CPC 5 (brain death). We defined the good neurological recovery as CPC 1 or CPC 2. This information will be collected from medical record review.

Outcome measures

Outcome measures
Measure	Districts Which Implement Newer DA-BLS Training Program n=1486 Participants the out of hospital cardiac arrest victims who were given bystander CPR by whom trained as newer dispatcher-assisted BLS training program, which more focuses on cooperation with a dispatcher, from recognition to perform DA-CPR and hands-on practice. BLS CPR program with dispatcher assisted CPR simulation: the training program more focuses on cooperation with a dispatcher, from recognition to perform DA-CPR and hands-on practice.	Districts Which Keep Traditional BLS Training Program n=8641 Participants Control group commonly uses a one-hour training program which was developed by the Korea CDC. It focuses on detailed techniques of performing high-quality chest compressions.
Number of Participants With Good Neurological Recovery	42 Participants	316 Participants

Adverse Events

Newer DA-BLS Training Program

Serious events: 1401 serious events

Other events: 0 other events

Deaths: 1401 deaths

Current BLS Training Program

Serious events: 8090 serious events

Other events: 0 other events

Deaths: 8090 deaths

Serious adverse events

Serious adverse events
Measure	Newer DA-BLS Training Program n=1486 participants at risk A 30-minute video-based self-instruction (VSI) training session, a short role-play, and a debriefing. The video consists of a bystander CPR simulation with dispatcher instructions using the trainee's own phone and practice session following demonstration by a simulated layperson. After watching the video clip, all trainees are divided into two groups and conduct a role-play as dispatchers and laypersons for 15 minutes. Finally, there is a 15-minute debriefing session with several assignments. The HEROS program focuses on cooperation with a dispatcher, from recognition of cardiac arrest to performing DA-CPR, with hands-on practice so that laypersons can provide bystander CPR immediately in a real situation. Moreover, the HEROS program emphasizes practice for providing the correct address of the scene and switching to speakerphone mode, especially for the elderly.	Current BLS Training Program n=8641 participants at risk A one-hour training program that was developed by the Korea CDC and it was based on the AHA BLS provider course (http://www.cdc.go.kr/board.es?mid=a20503050000\&bid=0021\&tag=\&act=view\&list\_no=127655). The program consists of a 30-minute VSI, and a 30-minute practice debriefing session. It focuses on detailed techniques for performing high-quality chest compressions including the correct hands and body position of the bystanders.
Cardiac disorders death	94.3% 1401/1486 • from date of discharge, assessed up to 3 months 1,401 cardiac arrest patients are died in the districts which implement new DA-BLS Training program. 8,090 cardiac arrest patients are died in the districts which keep current BLS Training program.	93.6% 8090/8641 • from date of discharge, assessed up to 3 months 1,401 cardiac arrest patients are died in the districts which implement new DA-BLS Training program. 8,090 cardiac arrest patients are died in the districts which keep current BLS Training program.

Other adverse events

Adverse event data not reported

Additional Information

Dr. Gwan Jin Park

Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute

Phone: 82-10-7477-3293

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place