Emergency Response System Improvements for Cardiac Arrest
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.12345Why 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?
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
Exclusion Criteria
Timeline for a Trial Participant
Start-up
Recruitment and randomization of county clusters
Intervention Training
Training phase for community CPR/AED, 911 dispatch optimization, and first responder performance improvement
Intervention
Implementation of the intervention across 50 counties
Follow-up
Assessment of quality of life in survivors of out-of-hospital cardiac arrest
Close-out and Data Analysis
Final data collection and analysis period
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?
2
Treatment groups
Experimental Treatment
Active Control
Mass community CPR/AED training, optimize 911 medical dispatch, improve first responder performance
Usual care, continuing standard quality improvement effort
Find a Clinic Near You
Who Is Running the Clinical Trial?
Duke University
Lead Sponsor
National Heart, Lung, and Blood Institute (NHLBI)
Collaborator
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 Stats
CPR, 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 & Statistics
For 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 & Statistics
For 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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