Multi-centre implementation of an Educational program to improve the Cardiac Arrest diagnostic accuracy of ambulance Telecommunicators and survival outcomes for sudden cardiac arrest victims: the EduCATe study design and methodology.
Dublin Core
Title
Multi-centre implementation of an Educational program to improve the Cardiac Arrest diagnostic accuracy of ambulance Telecommunicators and survival outcomes for sudden cardiac arrest victims: the EduCATe study design and methodology.
Subject
Cardiac arrest, Agonal breathing, Telecommunicators, Cardiopulmonary resuscitation, Resuscitation,
Emergency medical services
Emergency medical services
Description
Background
Sudden cardiac death remains a leading cause of mortality in Canada, resulting in more than 35,000 deaths
annually. Most cardiac arrest victims collapse in their own home (85% of the time) and 50% are witnessed by a
family member or bystander. Survivors have a quality of life similar to the general population, but the overall
survival rate for out-of-hospital cardiac arrest (OHCA) rarely exceeds 8%. Victims are almost four times more
likely to survive when receiving bystander CPR, but bystander CPR rates have remained low in Canada over the
past decade, not exceeding 15-25% until recently. Telecommunication-assisted CPR instructions have been
shown to significantly increase bystander CPR rates, but agonal breathing may be misinterpreted as a sign of life
by 9-1-1 callers and telecommunicators, and is responsible for as much as 50% of missed OHCA diagnoses.
We sought to improve the ability and speed with which ambulance telecommunicators can recognize OHCA over
the phone, initiate timely CPR instructions, and improve survival.
Methods
In this multi-center national study, we will implement and evaluate an educational program developed for
ambulance telecommunicators using a multiple baseline interrupted time-series design. We will compare
outcomes 12 months before and after the implementation of a 20-min theory-based educational video addressing
barriers to recognition of OHCA while in the presence of agonal breathing. Participating Canadian sites
demonstrated prior ability to collect standardized data on OHCA. Data will be collected from eligible 9-1-1
recordings, paramedic documentation and hospital medical records. Eligible cases will include suspected or
confirmed OHCA of presumed cardiac origin in patients of any age with attempted resuscitation.
Discussion
The ability of telecommunication-assisted CPR instructions to improve bystander CPR and survival rates for
OHCA victims is undeniable. The ability of telecommunicators to recognize OHCA over the phone is
unequivocally impeded by relative lack of training on agonal breathing, and reluctance to initiate CPR instructions
when in doubt. Our pilot data suggests the potential impact of this project will be to increase absolute OHCA
recognition and bystander CPR rates by at least 10%, and absolute out-of-hospital cardiac arrest survival by 5%
or more.
Sudden cardiac death remains a leading cause of mortality in Canada, resulting in more than 35,000 deaths
annually. Most cardiac arrest victims collapse in their own home (85% of the time) and 50% are witnessed by a
family member or bystander. Survivors have a quality of life similar to the general population, but the overall
survival rate for out-of-hospital cardiac arrest (OHCA) rarely exceeds 8%. Victims are almost four times more
likely to survive when receiving bystander CPR, but bystander CPR rates have remained low in Canada over the
past decade, not exceeding 15-25% until recently. Telecommunication-assisted CPR instructions have been
shown to significantly increase bystander CPR rates, but agonal breathing may be misinterpreted as a sign of life
by 9-1-1 callers and telecommunicators, and is responsible for as much as 50% of missed OHCA diagnoses.
We sought to improve the ability and speed with which ambulance telecommunicators can recognize OHCA over
the phone, initiate timely CPR instructions, and improve survival.
Methods
In this multi-center national study, we will implement and evaluate an educational program developed for
ambulance telecommunicators using a multiple baseline interrupted time-series design. We will compare
outcomes 12 months before and after the implementation of a 20-min theory-based educational video addressing
barriers to recognition of OHCA while in the presence of agonal breathing. Participating Canadian sites
demonstrated prior ability to collect standardized data on OHCA. Data will be collected from eligible 9-1-1
recordings, paramedic documentation and hospital medical records. Eligible cases will include suspected or
confirmed OHCA of presumed cardiac origin in patients of any age with attempted resuscitation.
Discussion
The ability of telecommunication-assisted CPR instructions to improve bystander CPR and survival rates for
OHCA victims is undeniable. The ability of telecommunicators to recognize OHCA over the phone is
unequivocally impeded by relative lack of training on agonal breathing, and reluctance to initiate CPR instructions
when in doubt. Our pilot data suggests the potential impact of this project will be to increase absolute OHCA
recognition and bystander CPR rates by at least 10%, and absolute out-of-hospital cardiac arrest survival by 5%
or more.
Creator
Christian Vaillancourt, Manya Charette, Sarika Naidoo, Monica Taljaard, Matthew Church and Stephanie Hodges
Publisher
BMC Emergency Medicine
Date
Mar. 4, 2021
Contributor
Fajar bagus W
Format
PDF
Language
Indonesia
Type
Text
Files
Collection
Citation
Christian Vaillancourt, Manya Charette, Sarika Naidoo, Monica Taljaard, Matthew Church and Stephanie Hodges, “Multi-centre implementation of an Educational program to improve the Cardiac Arrest diagnostic accuracy of ambulance Telecommunicators and survival outcomes for sudden cardiac arrest victims: the EduCATe study design and methodology.,” Repository Horizon University Indonesia, accessed September 20, 2024, https://repository.horizon.ac.id/items/show/3772.