Dispatcher-Assisted CPR: Low-Dose, High-Frequency Simulation-Based Training

NCT ID: NCT04085692

Last Updated: 2020-01-23

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 52 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2019-09-12
• Study Completion Date: 2019-12-25

Brief Summary

Clear, concise, yes, and no answers can be challenging to achieve in the assessment of consciousness and breathing in out-of-hospital cardiac arrest (OHCA) calls. Often callers will provide an unclear response, and this can lead to hesitation on the part of the Emergency Medical Dispatcher (EMD). Further, the relatively small proportion OHCA calls represent might demand the need for simulation training in the dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) guiding itself. Therefore, the investigators investigate whether low-dose, high-frequency (LDHF) simulation-based training of EMDs can increase the quality of DA-CPR in a simulation setting. Additionally, the investigators measure whether the effect of the training will be transferred to real OHCA calls.

The study is a randomised controlled trial comparing LDHF simulation-based training to standard quality improvement of the EMD in a single centre. The study protocol is structured according to the SPIRIT 2013 statement, and the study will be reported in compliance with the CONSORT 2010 Statement. The investigators chose EMDs receiving standard quality improvement as the comparator group, to reflect a representative cohort of the EMDs not exposed to the LDHF simulation-based training program.

The aims of this study are:

1. To measure the effect of LDHF simulation-based training on the quality of DA-CPR in a simulation setting.

2. To measure the effect of LDHF simulation-based training on the quality of DA-CPR in real OHCA calls.

The investigators hypothesise that LDHF simulation-based training will increase the quality of DA-CPR in the intervention group in a simulation setting and that this improvement is transferred to real OHCA calls - although the effect in real OHCA calls might be smaller due to the complexity of some calls. The investigators hypothesise that this improvement can be detected as a decrease in time to first bystander compression (TTFC), an increase in clarification of consciousness and breathing without asking additional questions, a decrease in time to recognition of cardiac arrest, and an increase in calls where the EMD provide DA-CPR instructions on patients in cardiac arrest.

Conditions

Out-Of-Hospital Cardiac Arrest

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: SINGLE

Study Groups

Intervention

The intervention group begins LDHF dispatcher training with one introduction week followed by twelve weeks of LDHF training.

During the study period, all regular quality improvement (QI) activities, such as self-audits, case reviews, mentor groups, and status meetings will continue for all EMDs.

Group Type: EXPERIMENTAL

Low-Dose, High-Frequency Simulation-Based Training

Intervention Type: BEHAVIORAL

Twelve weeks of LDHF training

The simulation-based training sessions take place at the EMDC, at extra workstations set-up as ordinary EMD workstations in an out-of-the-way area. Before each session, the EMD is informed about the simulation call and receives instructions concerning technical differences from a regular call. The instructor acts as a "standardised caller", guided by a computer program. This program, the Danish version of Resuscitation Quality Improvement for Telecommunicators (Laerdal Medical AS, Stavanger, Norway), is a training program for DA-CPR based on the simulation platform Laerdal Learning Application. This modified version of the RQI-T program has, one test scenario, one data collection scenario and six different cardiac arrests scenarios as well as a feedback checklist based on the Danish dispatcher protocol Danish Index for Emergency Care.

Each simulation session takes approximately 20 minutes, including introduction and feedback

Comparison

During the study period, all regular quality improvement (QI) activities, such as self-audits, case reviews, mentor groups, and status meetings will continue for all EMDs.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Low-Dose, High-Frequency Simulation-Based Training

Twelve weeks of LDHF training

The simulation-based training sessions take place at the EMDC, at extra workstations set-up as ordinary EMD workstations in an out-of-the-way area. Before each session, the EMD is informed about the simulation call and receives instructions concerning technical differences from a regular call. The instructor acts as a "standardised caller", guided by a computer program. This program, the Danish version of Resuscitation Quality Improvement for Telecommunicators (Laerdal Medical AS, Stavanger, Norway), is a training program for DA-CPR based on the simulation platform Laerdal Learning Application. This modified version of the RQI-T program has, one test scenario, one data collection scenario and six different cardiac arrests scenarios as well as a feedback checklist based on the Danish dispatcher protocol Danish Index for Emergency Care.

Each simulation session takes approximately 20 minutes, including introduction and feedback

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• EMD employed at the Copenhagen EMS at the time of enrolment.

Exclusion Criteria

• Mean working time as call taker at Copenhagen EMS < 8 hours/week.
• Planned employment cessation at the Copenhagen EMS during the data collection period.
• Planned leave from work longer than four weeks during the data collection period.
• Starting employment at the Copenhagen EMS during the study period.

• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

TrygFonden, Denmark

INDUSTRY

Sponsor Role: collaborator

Emergency Medical Services, Capital Region, Denmark

OTHER_GOV

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Freddy Lippert, MD

Role: PRINCIPAL_INVESTIGATOR

Emergency Medical Services, Capital Region, Denmark

Oscar Rosenkrantz

Role: STUDY_DIRECTOR

Emergency Medical Services, Capital Region, Denmark

Locations

Copenhagen Emergency Medical Services

Copenhagen, , Denmark

Countries

Denmark

Provided Documents

Document Type: Study Protocol and Statistical Analysis Plan: Full protocol

View Document

Document Type: Informed Consent Form

View Document

Document Type: Study Protocol: Supplementary assessment points for table 1

View Document

Other Identifiers

DTP

Identifier Type: -

Identifier Source: org_study_id