Dispatcher-Assisted Resuscitation Trial (DART)

Public Health - Seattle and King County

Status and phase: Completed; Phase 3

Conditions: Heart Arrest

Treatments: Other: dispatcher-assisted CPR with compressions & ventilations; Other: dispatcher-assisted CPR instructions with compressions only

Study type: Interventional

Funder types: Other

Identifiers

NCT00219687

RARC-0001-01

Details and patient eligibility

About

The purpose of this study is to determine whether dispatcher-assisted CPR instructions with compressions and ventilations versus dispatcher-assisted CPR instructions with compressions only improves survival from out-of-hospital cardiac arrests.

Full description

Out-of-hospital cardiac arrest, a condition characterized by a person suddenly collapsing due to heart stoppage, is a leading cause of death in the United States. In out-of-hospital cardiac arrest, survival is dependent upon what the American Heart Association has termed the chain of survival which includes quick activation of the 9-1-1 system, prompt cardiopulmonary resuscitation (CPR), early defibrillation, and qualified advanced life support care (paramedic care). CPR allows for some circulation and delivery of oxygen to vital organs when the heart is no longer beating on its own. However, in some instances, the citizen bystander has not been trained in CPR, presenting a circumstance where the cardiac arrest victim may not receive CPR until the arrival of emergency medical services (EMS) personnel (i.e., paramedics). The delay in CPR adversely affects outcome and dcreases the chance of survival. In response to this need, the EMS Division of Public Health - Seattle and King County developed and instituted telephone CPR instructions that could be provided "on-the-spot" during a cardiac arrest by the emergency medical (9-1-1) dispatcher. The instructions are designed to be given over the phone to persons who have not had previous CPR training so that they can initiate CPR prior to the arrival of EMS personnel and have been termed "dispatcher-assisted" CPR. The dispatcher instructions provided by the dispatch agencies of King County include the standard "full" CPR protocol of ventilations (breathing into the victim's mouth to inflate the lungs) and chest compressions(pumping on the patients chest to help circulate the blood). The ventilations oxygenate the blood while the chest compressions pump the oxygenated blood forward. This EMS program has led to a considerable increase in the proportion of cardiac arrest victims in King County that receive citizen bystander CPR prior to EMS arrival and has been associated with improved survival (appendix 1).

Comparison: Dispatcher-assisted CPR instructions with compressions and ventillations compared to dispatcher-assisted CPR instructions with compressions only.

Enrollment: 5,494 patients

Sex: All

Ages: 9+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Cardiac arrest events where CPR is not ongoing but a bystander is willing to attempt with assistance

Exclusion criteria

• Pregnancy
• Prisoners
• Cardiac arrest due to asphyxia, drowning, hanging, or electrocution

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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5,494 participants in 2 patient groups

1

Active Comparator group

Description:

When a 911 call is determined to be a cardiac arrest, the caller reporting the event who needs or desires instructions to perform CPR while waiting for EMS to arrive will receive dispatcher-assisted CPR instructions with chest compressions only

Treatment:

Other: dispatcher-assisted CPR instructions with compressions only

2

Active Comparator group

Description:

When a 911 call is determined to be a cardiac arrest, the caller reporting the event who needs or desires instructions to perform CPR while waiting for EMS to arrive will receive dispatcher-assisted CPR instructions with chest compressions and breaths

Treatment:

Other: dispatcher-assisted CPR with compressions & ventilations