Out-Of-Hospital Cardiac ArrestNCT04061187
Livestreaming From Smartphones as a Supplement to Emergency Calls
An observational study of Out-Of-Hospital Cardiac Arrest and Emergencies, run by Emergency Medical Services, Capital Region, Denmark at 1 site in Denmark.
Trial summary
The aim of the study is to analyse if live video as a supplement to emergency calls can improve medical dispatchers' situation awareness and enhance the assistance they provide including provision of pre-hospital resources. Focus will also be on evaluating the unconscious patient and improve CPR quality. Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Out-Of-Hospital Cardiac Arrest, Emergencies, Unconscious
- How many people
- 700 participants
- Where
- 1 siteDenmark
- Study dates
- 1 Oct 2018to 1 Mar 2020
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Study population: Emergency medical dispatchers in Copenhagen who added live video footage to the emergency call
Who may be able to join
- Inclusion criteria (stream live video footage) These are assessed by the medical dispatcher before stream of live video footage.
- Emergency call about an unconscious patient. (The patient is defined as unconscious, if the patient is unresponsive to verbal or pain stimulus according to the Danish Index. (Inclusion criterion in relation to the Danish Index is "unconscious patient with normal breathing. A.01.03", as well as all sub-criteria that meet the above criteria e.g. "A.06.01, Unresolved problem;" Does not respond to call or pain stimulus, but no breathing problems ").
- Emergency call about suspected cardiac arrest where CPR is provided
- Emergency call about a patient with trauma/illness where the medical dispatcher thinks it will be a benefit with live video footage
- Video-capable smartphone present
- Caller by the patient's side
- Caller expected age≥ 18 years
- More than two bystanders present
Who cannot join
- If caller, patient or other bystanders do not want livestreaming to be added to the emergency call.
- No video-capable smartphone present
- Caller not by the patient's side
- Caller a child
- Less than two bystanders present
Trial locations and contacts
1 site in 1 country.
Denmark1 site
Copenhagen Emergency Medical Services
Copenhagen, Ballerup, 2750
About this study
The aim of the study is to analyse if live video as a supplement to emergency calls can improve medical dispatchers' situation awareness and enhance the assistance they provide including provision of pre-hospital resources. Focus will also be on evaluating the unconscious patient and improve CPR quality.
The general experience from the medical dispatcher and the person calling the emergency number regarding the feasibility of adding live video will also be analysed.
Read the detailed description
Setting; The study will be conducted in Copenhagen Emergency Medical Services (EMS), which covers a population of approximately 1.84 million people and an area of 2559 km2. In case of an emergency, there is a single emergency phone number (1-1-2) to a call center that identifies the need for police, fire or medical assistance. If the problem is medical, the caller is re-directed to the EMS where medical dispatchers answer, process and respond to the call by activating the appropriate EMS response and delivering medical advice.
In every emergency call, the medical dispatcher starts by asking the caller about the nature of the problem and whether the patient is awake and breathing normally. In case of suspected cardiac arrest, the dispatcher follows a guideline for dispatcher assisted cardiopulmonary resuscitation based on the European Resuscitation Council Guidelines for Resuscitation. The medical dispatchers are specially trained registered nurses or paramedics with experience within emergency care. They all have a basic life support course and advanced course in DA-CPR. Their decision-making process is supported by a criteria-based, nationwide Emergency Medical Dispatch System (Danish Index), which is a validated tool for managing emergency calls for the most urgent cases of emergencies. The instructions in DA-CPR is divided into two depending on whether the bystander have received a basic CPR course (BLS course). If the bystanders have a BLS course they are also instructed in ventilation. Instructions to lay people consist of short commands. E.g., "place the victim in the supine position". All medical dispatcher has a metronome available to support they guidance. The medical dispatcher guide bystander until ambulance arrival.
Methods; When the medical dispatcher receives an emergency call they decide emergency priority level, dispatch vehicle type and competence allocation and guide in CPR as before the study. Afterwards then can add livestreaming to the emergency call. Each medical dispatcher can choose in which emergency call they want to add live video, but they are recommended to do it with all unconscious patients including cardiac arrest after bystander CPR is started.
Technical solution; For livestreaming of video footage the dispatcher sends a text message, asking the caller to give their consent to share stream video from their camera on their smartphone. When the caller confirms consent, the smartphone automatically starts securely transmitting a video live stream from the scene back to the medical dispatcher. When the emergency call is finished the link will be inactivated.
Data collection and outcome; All medical dispatchers will participate. After each emergency call with stream of live video the medical dispatcher fills out a questionnaire about their evaluations of the patient before and after live video, if the live video resulted in changed treatment of the patient, or different response. Emergency priority level, emergency response, date and time for the call and symptom-based criteria from Danish Index (1-39 items) will be collected from the dispatch system Logis CAD and compared with emergency calls without use of live video.
The person calling the emergency number 1-1-2 and accepted transmission of live video to the emergency medical dispatcher will afterwards receive a text message with a questionnaire about their experience. We will collect data for aprox. 500 emergency calls where live video is added to the call including around 200 cases with unconscious patients and 53 cases with cardiac arrest patients. We will analyse the change in CPR quality before the medical dispatcher assist in CPR using live video and after the medical dispatcher has assisted. The first evaluation of CPR quality will be as soon as possible from the streamed video and the after score will be registered when the CPR is optimized as much as possible.
- Conditions
- Out-Of-Hospital Cardiac Arrest, Emergencies, Unconscious
- Keywords
- Dispatcher, Dispatcher-assisted cardiopulmonary resuscitation, Emergency call, Live video
- Medical subject headings
- Out-of-Hospital Cardiac Arrest, Emergencies, Unconsciousness
What is being measured
The primary outcome is the main question the study is designed to answer.
Changed emergency response after adding live video to the emergency call
Did the medical dispatcher change emergency response more often after live video was added to the emergency call compared to emergency calls without video.
Measured: From the beginning of the emergency call to the end of the call. Approx. 6-7 minutes
The medical dispatcher's evaluations of the patient after adding live video footage to the emergency call.
Did the medical dispatcher's evaluation of the patient change because of the live video footage? (ANSWER: Yes, patient more critical ill/ Yes, less critical ill/ or no change) Did the patient suffer another trauma/disease compared to what the medical dispatcher thought before the live video footage? (ANSWER: No/Yes (describe)).
Measured: From the beginning of the emergency call to the end of the call. Approx. 6-7 minutes
The medical dispatcher's evaluations of the patient's level of consciousness before and after adding live video footage to the emergency call.
The medical dispatcher evaluate the patient's level of consciousness before and after the live video footage; AVPU scale (an acronym from "alert, verbal, pain, unresponsive") /or inaccessible.
Measured: From the beginning of the emergency call to the end of the call. Approx. 6-7 minutes.
The medical dispatcher's evaluations of the surroundings and bystander response after adding live video footage to the emergency call.
Did the medical dispatcher situation's awareness regarding the surroundings or bystander response change after video footage? (ANSWER: No/ Yes, Less bystanders present/ Yes, more bystanders present/ Yes, bystander response were more sufficient/ Yes, bystander response were less sufficient/Yes, surroundings were different(describe)/ other (describe)).
Measured: From the beginning of the emergency call to the end of the call. Approx. 6-7 minutes.
The medical dispatcher's evaluations of the usefulness of adding live video footage to the emergency call.
Was the live video footage useful for the medical dispatcher"? (ANSWER: Extremely useful/ very useful/ moderately useful/ slightly useful/ not at all useful).
Measured: From the beginning of the emergency call to the end of the call. Approx. 6-7 minutes.
Change in emergency level after adding live video footage to the emergency call.
Did the medical dispatcher change emergency priority level because of the live video footage?" (ANSWER: No, Yes (upgrade, downgrade))
Measured: Evaluated at the end of the emergency call.
Change in the CPR quality (hand position) before the medical dispatcher assist in CPR using the video footage (video-DA-CPR) and after the medical dispatcher has assisted .
Correct hand position before and after video-DA-CPR? (Outcome: yes / no / inaccessible evaluated before and after video-DA-CPR)
Measured: From the medical dispatcher receive video footage until the end of video-DA-CPR.
Change in the CPR quality (compressions rate) before and after video-DA-CPR.
Correct compressions rate (100-120 compressions/min) before and after video-DA-CPR (Outcome: yes / no / inaccessible evaluated before and after video-DA-CPR)
Measured: From the medical dispatcher receive video footage until the end of video-DA-CPR.
Change in the CPR quality (compressions depth) before and after video-DA-CPR
Correct compressions depth before and after video-DA-CPR (approximately one third of the anterior-posterior diameter). (Outcome: yes / no / inaccessible evaluated before and after video-DA-CPR)
Measured: From the medical dispatcher receive video footage until the end of video-DA-CPR.
Secondary outcomes (6)
"Hands-of-time" during CPR
Does the medical dispatcher initiate less "hands-of-time" during CPR after receiving live video footage? "Hands-off-time" is the time with no chest compressions. (ANSWER: does the dispatcher initiate less "hands-of-time"?(yes/No))
Measured: From the medical dispatcher receive video footage until the end of the call. Approx. 5-6 minutes.
Ventilations performed by bystanders?
Correct ventilations before and after video-DA-CPR? (Outcome: yes / no / inaccessible evaluated before and after video-DA-CPR).
Measured: From the medical dispatcher receive video footage until the end of video-DA-CPR.
Shift of persons during CPR
Shift of persons during CPR? (Outcome:yes/no), does bystander initiate this by themselves or guide by the dispatcher?
Measured: From the medical dispatcher receive video footage until the end of the call. Approx. 5-6 minutes.
Use of AED
Correct attachment of AED pads (Outcome:yes/no), If "no" does the dispatcher initiate correct use?
Measured: From the medical dispatcher receive video footage until the end of the call. Approx. 5-6 minutes.
Other aspects of bystander CPR
Did the dispatcher assist in other aspects of CPR? (describe)
Measured: From the medical dispatcher receive video footage until the end of the call. Approx. 5-6 minutes.
Bystanders experiance with adding live video to the emergency call
Bystanders' evaluation of the potential help and challenges with adding live video to the emergency call
Measured: From the person calling 1-1-2 accept transmission of live video until end of the call. Approx. 5-6 minutes.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Aug 2019
- Study start1 Oct 2018
- Primary completion1 Mar 2020
- Study completion1 Mar 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Out-Of-Hospital Cardiac ArrestStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case only
- Time perspective
- Other
- Enrolment
- 700 participants (actual)
Sponsor and investigators
- Lead sponsor
- Emergency Medical Services, Capital Region, Denmark
- Sponsor type
- Other government
- Collaborators
- The Danish foundation TrygFonden
- Responsible party
- Sponsor
- Investigators
- Freddy K. Lippert, MD, CEO, Principal investigator, Copenhagen Emergency Medical ServicesFredrik Folke, MD, PhD, Study chair, Copenhagen Emergency Medical ServicesChristian S. Meyhoff, MD, PhD, Study chair, Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, DenmarkDoris Øestergaard, MD, Prof., Study chair, Copenhagen Academy for Medical Education and Simulation, Denmark.Gitte Linderoth, MD, Study director, Copenhagen Emergency Medical Services
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04061187
- Sponsor's protocol ID
- F-35150-03
- Status last verified
- Sep 2021
- First submitted
- 14 Aug 2019
- Last updated
- 14 Sep 2021
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 14 Sep 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Livestreaming From Smartphones as a Supplement to Emergency Calls
- ClinicalTrials.gov ID
- NCT04061187
- Acronym / sponsor ID
- F-35150-03
- Conditions
- Out-Of-Hospital Cardiac Arrest, Emergencies, Unconscious
- Keywords
- Dispatcher, Dispatcher-assisted cardiopulmonary resuscitation, Emergency call, Live video
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 700 participants (actual)
- Lead sponsor
- Emergency Medical Services, Capital Region, DenmarkOther government
- Collaborators
- The Danish foundation TrygFonden
- Study start
- 1 Oct 2018 (actual)
- Primary completion
- 1 Mar 2020 (actual)
- Study completion
- 1 Mar 2020 (actual)
- First posted
- 19 Aug 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of the study is to analyse if live video as a supplement to emergency calls can improve medical dispatchers' situation awareness and enhance the assistance they provide including provision of pre-hospital resources. Focus will also be on evaluating the unconscious patient and improve CPR quality.
The general experience from the medical dispatcher and the person calling the emergency number regarding the feasibility of adding live video will also be analysed.
Detailed description
Setting; The study will be conducted in Copenhagen Emergency Medical Services (EMS), which covers a population of approximately 1.84 million people and an area of 2559 km2. In case of an emergency, there is a single emergency phone number (1-1-2) to a call center that identifies the need for police, fire or medical assistance. If the problem is medical, the caller is re-directed to the EMS where medical dispatchers answer, process and respond to the call by activating the appropriate EMS response and delivering medical advice.
In every emergency call, the medical dispatcher starts by asking the caller about the nature of the problem and whether the patient is awake and breathing normally. In case of suspected cardiac arrest, the dispatcher follows a guideline for dispatcher assisted cardiopulmonary resuscitation based on the European Resuscitation Council Guidelines for Resuscitation. The medical dispatchers are specially trained registered nurses or paramedics with experience within emergency care. They all have a basic life support course and advanced course in DA-CPR. Their decision-making process is supported by a criteria-based, nationwide Emergency Medical Dispatch System (Danish Index), which is a validated tool for managing emergency calls for the most urgent cases of emergencies. The instructions in DA-CPR is divided into two depending on whether the bystander have received a basic CPR course (BLS course). If the bystanders have a BLS course they are also instructed in ventilation. Instructions to lay people consist of short commands. E.g., "place the victim in the supine position". All medical dispatcher has a metronome available to support they guidance. The medical dispatcher guide bystander until ambulance arrival.
Methods; When the medical dispatcher receives an emergency call they decide emergency priority level, dispatch vehicle type and competence allocation and guide in CPR as before the study. Afterwards then can add livestreaming to the emergency call. Each medical dispatcher can choose in which emergency call they want to add live video, but they are recommended to do it with all unconscious patients including cardiac arrest after bystander CPR is started.
Technical solution; For livestreaming of video footage the dispatcher sends a text message, asking the caller to give their consent to share stream video from their camera on their smartphone. When the caller confirms consent, the smartphone automatically starts securely transmitting a video live stream from the scene back to the medical dispatcher. When the emergency call is finished the link will be inactivated.
Data collection and outcome; All medical dispatchers will participate. After each emergency call with stream of live video the medical dispatcher fills out a questionnaire about their evaluations of the patient before and after live video, if the live video resulted in changed treatment of the patient, or different response. Emergency priority level, emergency response, date and time for the call and symptom-based criteria from Danish Index (1-39 items) will be collected from the dispatch system Logis CAD and compared with emergency calls without use of live video.
The person calling the emergency number 1-1-2 and accepted transmission of live video to the emergency medical dispatcher will afterwards receive a text message with a questionnaire about their experience. We will collect data for aprox. 500 emergency calls where live video is added to the call including around 200 cases with unconscious patients and 53 cases with cardiac arrest patients. We will analyse the change in CPR quality before the medical dispatcher assist in CPR using live video and after the medical dispatcher has assisted. The first evaluation of CPR quality will be as soon as possible from the streamed video and the after score will be registered when the CPR is optimized as much as possible.
Study design
- Observational model
- Case only
- Time perspective
- Other
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
- Study population
- Emergency medical dispatchers in Copenhagen who added live video footage to the emergency call
Key inclusion criteria (8 listed)
- Inclusion criteria (stream live video footage) These are assessed by the medical dispatcher before stream of live video footage.
- Emergency call about an unconscious patient. (The patient is defined as unconscious, if the patient is unresponsive to verbal or pain stimulus according to the Danish Index. (Inclusion criterion in relation to the Danish Index is "unconscious patient with normal breathing. A.01.03", as well as all sub-criteria that meet the above criteria e.g. "A.06.01, Unresolved problem;" Does not respond to call or pain stimulus, but no breathing problems ").
- Emergency call about suspected cardiac arrest where CPR is provided
- Emergency call about a patient with trauma/illness where the medical dispatcher thinks it will be a benefit with live video footage
- Video-capable smartphone present
Key exclusion criteria (5 listed)
- If caller, patient or other bystanders do not want livestreaming to be added to the emergency call.
- No video-capable smartphone present
- Caller not by the patient's side
- Caller a child
- Less than two bystanders present
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Changed emergency response after adding live video to the emergency call
Time frame: From the beginning of the emergency call to the end of the call. Approx. 6-7 minutes
Did the medical dispatcher change emergency response more often after live video was added to the emergency call compared to emergency calls without video.
The medical dispatcher's evaluations of the patient after adding live video footage to the emergency call.
Time frame: From the beginning of the emergency call to the end of the call. Approx. 6-7 minutes
Did the medical dispatcher's evaluation of the patient change because of the live video footage? (ANSWER: Yes, patient more critical ill/ Yes, less critical ill/ or no change) Did the patient suffer another trauma/disease compared to what the medical dispatcher thought before the live video footage? (ANSWER: No/Yes (describe)).
The medical dispatcher's evaluations of the patient's level of consciousness before and after adding live video footage to the emergency call.
Time frame: From the beginning of the emergency call to the end of the call. Approx. 6-7 minutes.
The medical dispatcher evaluate the patient's level of consciousness before and after the live video footage; AVPU scale (an acronym from "alert, verbal, pain, unresponsive") /or inaccessible.
The medical dispatcher's evaluations of the surroundings and bystander response after adding live video footage to the emergency call.
Time frame: From the beginning of the emergency call to the end of the call. Approx. 6-7 minutes.
Did the medical dispatcher situation's awareness regarding the surroundings or bystander response change after video footage? (ANSWER: No/ Yes, Less bystanders present/ Yes, more bystanders present/ Yes, bystander response were more sufficient/ Yes, bystander response were less sufficient/Yes, surroundings were different(describe)/ other (describe)).
The medical dispatcher's evaluations of the usefulness of adding live video footage to the emergency call.
Time frame: From the beginning of the emergency call to the end of the call. Approx. 6-7 minutes.
Was the live video footage useful for the medical dispatcher"? (ANSWER: Extremely useful/ very useful/ moderately useful/ slightly useful/ not at all useful).
Change in emergency level after adding live video footage to the emergency call.
Time frame: Evaluated at the end of the emergency call.
Did the medical dispatcher change emergency priority level because of the live video footage?" (ANSWER: No, Yes (upgrade, downgrade))
Change in the CPR quality (hand position) before the medical dispatcher assist in CPR using the video footage (video-DA-CPR) and after the medical dispatcher has assisted .
Time frame: From the medical dispatcher receive video footage until the end of video-DA-CPR.
Correct hand position before and after video-DA-CPR? (Outcome: yes / no / inaccessible evaluated before and after video-DA-CPR)
Change in the CPR quality (compressions rate) before and after video-DA-CPR.
Time frame: From the medical dispatcher receive video footage until the end of video-DA-CPR.
Correct compressions rate (100-120 compressions/min) before and after video-DA-CPR (Outcome: yes / no / inaccessible evaluated before and after video-DA-CPR)
Change in the CPR quality (compressions depth) before and after video-DA-CPR
Time frame: From the medical dispatcher receive video footage until the end of video-DA-CPR.
Correct compressions depth before and after video-DA-CPR (approximately one third of the anterior-posterior diameter). (Outcome: yes / no / inaccessible evaluated before and after video-DA-CPR)
6 secondary outcomes
"Hands-of-time" during CPR
Time frame: From the medical dispatcher receive video footage until the end of the call. Approx. 5-6 minutes.
Ventilations performed by bystanders?
Time frame: From the medical dispatcher receive video footage until the end of video-DA-CPR.
Shift of persons during CPR
Time frame: From the medical dispatcher receive video footage until the end of the call. Approx. 5-6 minutes.
Use of AED
Time frame: From the medical dispatcher receive video footage until the end of the call. Approx. 5-6 minutes.
Other aspects of bystander CPR
Time frame: From the medical dispatcher receive video footage until the end of the call. Approx. 5-6 minutes.
Bystanders experiance with adding live video to the emergency call
Time frame: From the person calling 1-1-2 accept transmission of live video until end of the call. Approx. 5-6 minutes.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Sep 2021.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Freddy K. Lippert, MD, CEO principal investigator
Copenhagen Emergency Medical Services
Fredrik Folke, MD, PhD study chair
Copenhagen Emergency Medical Services
Christian S. Meyhoff, MD, PhD study chair
Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, Denmark
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Out-Of-Hospital Cardiac Arrest and Emergencies, run by Emergency Medical Services, Capital Region, Denmark at 1 site in Denmark.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 14 Sep 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Changed emergency response after adding live video to the emergency call (time frame: From the beginning of the emergency call to the end of the call. Approx. 6-7 minutes). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Sep 2021.