Cardiac Arrest in Residential Areas With Mobile First-responder Activation (CARAMBA)

Emergency Medical Services, Capital Region, Denmark

Status: Enrolling

Conditions: Out-Of-Hospital Cardiac Arrest

Treatments: Other: Activation of citizen responders; Other: Training in cardiopulmonary resuscitation and AED use; Device: Automated External Defibrillator (AED)

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT04446585

111

Details and patient eligibility

About

The study aims to increase proportions of bystander defibrillation during out-of-hospital cardiac arrest (hereof referred to as cardiac arrest) in residential areas with a high density of cardiac arrests. The intervention consists of Automated External Defibrillators (AEDs) and residents' involvement in resuscitation through training and enrollment as citizen responders.

Full description

Survival decreases by 10% for every minute that passes after a cardiac arrest until defibrillation. Despite an increasing number of available AEDs, survival and defibrillation rates in residential areas remain poor. Efforts to increase bystander defibrillation has the potential to improve survival. Through the strategic deployment of AEDs, training, and recruitment of residents as citizen responders, we aim to improve proportions of bystander defibrillation and 30-day survival in densely populated residential areas with a high density of cardiac arrests.

Enrollment: 260 estimated patients

Sex: All

Ages: 8+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• All witnessed cardiac arrests recognized registered in the Danish Cardiac Arrest Registry occurring within the study sites. This excludes non witnessed cardiac arrests.
• Witnessed cardiac arrest
• Non-traumatic etiology, this excludes intoxication, drowning or suicide.

Exclusion criteria

• Cardiac arrest occurring in a nursing home
• Cardiac arrest not treated by the EMS due to ethical reasons or obvious signs of death
• Not true cardiac arrest (suspected, but not verified)
• Cardiac arrests witnessed by the emergency medical personnel

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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260 participants in 2 patient groups

Control sites

No Intervention group

Description:

For all 1-1-2 calls with suspected cardiac arrest to the emergency dispatch center will activate a two-tiered response consisting of dispatch of an ambulance with an emergency medical technician, a physician-staffed mobile emergency care unit, and citizen first responders through the Heart Runner app. The medical dispatcher offers telephone assisted cardiopulmonary resuscitation (CPR) to bystanders. Furthermore, if more than two bystanders are present and an AED is accessible within 1½ minute travel distance (depending on the type of terrain), then one bystander is guided to localize and retrieve the AED.

Intervention sites

Experimental group

Description:

As a supplement to the standard care as described in the control arm, the following will be supplied: Strategical deployment of AEDs with 24:7 availability and 1½ minute walking distance to every residence within the area. The AEDs will be registered with the AED network and thus linked to the emergency dispatch center. The emergency dispatch center will retrieve data from used AEDs. For each interventional area, approximately 120 residents will receive a course in CPR and AED use and subsequently be recruited as citizen responders so that they can be activated through the HeartRunner app in case of a nearby cardiac arrest.

Treatment:

Device: Automated External Defibrillator (AED)

Other: Training in cardiopulmonary resuscitation and AED use

Other: Activation of citizen responders