Emergency Response System Improvements for Cardiac Arrest

Enrolling by invitation at 1 trial location
LD
SB
KT
Overseen ByKimberly T. Ward, MPH
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Duke University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial seeks to improve how communities and first responders handle cardiac arrests occurring outside hospitals. It aims to train more people in CPR and the use of AEDs (devices that can restart the heart) and ensure that 911 operators and first responders act more quickly and effectively. The trial will compare communities receiving these enhancements to those continuing with usual care. It suits individuals who have experienced cardiac arrests outside a hospital where resuscitation was attempted. As an unphased trial, it offers participants the opportunity to contribute to community-wide improvements in emergency response.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these emergency response system improvements are safe for cardiac arrest patients?

Research has shown that teaching everyday people to perform CPR and use AEDs is both safe and effective. AEDs are safe to use even with little or no training and can save lives if used quickly after cardiac arrest. Studies have found that bystander CPR can significantly improve survival rates, with some research suggesting an increase of up to four times.

Moreover, getting first responders to use AEDs sooner boosts survival rates. When trained responders use AEDs, outcomes in sudden cardiac arrest cases improve.

Recognizing cardiac arrest quickly and calling emergency services immediately is crucial. Faster emergency response increases survival chances. One study found that quick dispatch of emergency services was linked to a higher chance of survival 30 days after cardiac arrest.

Finally, when 911 operators guide bystanders to perform CPR, it can double survival chances. Bystander CPR, even without mouth-to-mouth breathing, effectively improves outcomes.

Overall, these actions are well-tolerated and safe, as they focus on training and enhancing current emergency response practices.12345

Why are researchers excited about this trial?

Researchers are excited about these emergency response improvements for cardiac arrest because they aim to significantly boost survival rates. Unlike current methods that rely heavily on professional response, this approach empowers everyday people with comprehensive CPR and AED training, ensuring faster response times. Additionally, the optimized system enhances 911 dispatch protocols and first responder actions, leading to quicker recognition and treatment of cardiac arrest. These changes could transform how quickly and effectively help arrives, potentially saving more lives.

What evidence suggests that this trial's interventions could be effective for improving outcomes of out-of-hospital cardiac arrest?

This trial will compare an enhanced standard of care intervention with the current standard of care for cardiac arrest response. Studies have shown that teaching community members CPR and AED use can greatly increase survival rates for cardiac arrest victims, sometimes up to four times higher. Research also shows that quick AED use by first responders improves survival chances. Machine learning tools can help 911 operators identify cardiac arrest faster, leading to quicker emergency response, which can make a significant difference. Additionally, providing CPR instructions over the phone during an emergency call can significantly improve survival chances.16789

Who Is on the Research Team?

CG

Christopher Granger, MD

Principal Investigator

Duke University

Are You a Good Fit for This Trial?

The RACE-CARS trial is for patients who experience non-traumatic out-of-hospital cardiac arrest (OHCA) and are pulseless when first responders arrive or become pulseless in their presence. It's not for cases where resuscitation isn't attempted due to severe injuries, signs of death, decomposition, or a valid DNR order.

Inclusion Criteria

I was revived by a defibrillator before EMS arrived.
My cardiac arrest was not caused by an injury.
You don't have a pulse when the first responders arrive.
See 1 more

Exclusion Criteria

Private EMS transport that did not involve 911 dispatch (example: interfacility transport between nursing home and hospital)
I have not had a cardiac arrest without attempted resuscitation due to severe injuries or signs of death.
I was revived from a suspected heart attack without needing shocks or CPR from first responders.
See 1 more

Timeline for a Trial Participant

Start-up

Recruitment and randomization of county clusters

6 months

Intervention Training

Training phase for community CPR/AED, 911 dispatch optimization, and first responder performance improvement

12 months

Intervention

Implementation of the intervention across 50 counties

4 years

Follow-up

Assessment of quality of life in survivors of out-of-hospital cardiac arrest

12 months

Close-out and Data Analysis

Final data collection and analysis period

6 months

What Are the Treatments Tested in This Trial?

Interventions

  • Comprehensive community training of lay people in CPR and AED use.
  • Optimized first responder performance including earlier use of AEDs.
  • Rapid cardiac arrest recognition that triggers immediate priority EMS/first responder dispatch by 911 operators
  • Systematic bystander resuscitation instruction by 911 operators
Trial Overview This study tests a system-wide intervention in 50 North Carolina counties to improve cardiac arrest outcomes. It includes rapid EMS dispatch, optimized first responder actions like early AED use, community CPR/AED training, and systematic bystander instruction by 911 operators.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Intervention (Enhanced Standard of Care)Experimental Treatment4 Interventions
Group II: Control (Standard of Care)Active Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Duke University

Lead Sponsor

Trials
2,495
Recruited
5,912,000+

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator

Trials
3,987
Recruited
47,860,000+

Citations

A novel approach to community CPR and AED outreach ...Furthermore, early defibrillation by a bystander had significantly better outcomes (44% survived to discharge) when compared to defibrillation ...
Impact of community-based interventions on out-of-hospital ...Bystander cardiopulmonary resuscitation (CPR) and bystander-AED use have been shown to improve survival by up to fourfold in individual studies.
CPR Facts and StatsCPR, especially if administered immediately after cardiac arrest, can double or triple a person's chance of survival. According to 2021 US data for adult OHCA ...
Effect of cardiopulmonary resuscitation training for ...This study demonstrated that CPR training for laypersons was associated with increased ROSC rates in OHCA patients, indicating potential advantages of CPR ...
CPR Facts & StatisticsFor those adults who trained in CPR, AED, and First Aid, positive outcomes were reported: 69% felt more prepared, 63% felt more confident, and ...
CPR Facts & StatisticsFor the past 20 years, the survival rate for cardiac arrest has hovered around 10 percent for out-of-hospital incidences and 21 percent for in- ...
Factors and Barriers on Cardiopulmonary Resuscitation ...AED is effective in saving lives when used quickly following collapse, safe when used by laypeople with minimal or no training, and accurate. It ...
Part 1: Executive Summary: 2025 ...Bystander-witnessed adult arrests where bystander CPR was initiated had a 13.0% survival to hospital discharge compared with the 7.6% survival ...
Health inequalities in cardiopulmonary resuscitation and ...Immediate provision of CPR can increase survival rates by up to four times, and AED use within three to five minutes can improve survival rates by 50-70%. The ...
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