Out-of-hospital Cardiac Arrest (OHCA)TACTICNCT07546474
Telemedicine-Assisted vs Conventional Telephone Instruction in Cardiopulmonary Resuscitation
A study testing Telemedicine-Assisted CPR (TA-CPR) and Dispatcher-Assisted CPR (DA-CPR) in people with Out-of-hospital Cardiac Arrest (OHCA) and Emergency Medical Services, run by Siriraj Hospital at 1 site in Thailand.
Trial summary
Out-of-hospital cardiac arrest (OHCA) is a life-threatening emergency where early cardiopulmonary resuscitation (CPR) by bystanders can significantly improve survival. Emergency dispatchers often guide bystanders to perform CPR over the phone, a method known as dispatcher-assisted CPR (DA-CPR). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Out-of-hospital Cardiac Arrest (OHCA), Emergency Medical Services
- What is being tested?
- Telemedicine-Assisted CPR (TA-CPR) and Dispatcher-Assisted CPR (DA-CPR)
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 108 participants
- Where
- 1 siteThailand
- Study dates
- 1 Feb 2025to 31 Dec 2025
- Phase
- Interventional
- 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adult patients aged ≥18 years
- Suspected non-traumatic out-of-hospital cardiac arrest
- Managed by the participating advanced life support (ALS) EMS unit
Who cannot join
- Resuscitation declined by patient's relatives
- Cardiac arrest occurring in unsafe or inappropriate locations for EMS intervention
- EMS-witnessed cardiac arrest
- Inability of bystander to communicate in Thai
- Cases where ALS unit is not directly dispatched to the scene
Trial locations and contacts
1 site in 1 country.
Thailand1 site
Faculty of Medicine Siriraj Hospital, Mahidol University
Bangkok Noi, Bangkok, 10700
About this study
Out-of-hospital cardiac arrest (OHCA) is a life-threatening emergency where early cardiopulmonary resuscitation (CPR) by bystanders can significantly improve survival. Emergency dispatchers often guide bystanders to perform CPR over the phone, a method known as dispatcher-assisted CPR (DA-CPR). While this approach has increased bystander CPR rates worldwide, it relies on voice communication only, which may limit the dispatcher's ability to assess the situation and guide CPR effectively.
With advances in telecommunication technology, video-based communication has become more widely available. Telemedicine-assisted CPR (TA-CPR) allows dispatchers or emergency medical providers to see the patient and the rescuer through a live video call, potentially improving CPR performance by providing real-time visual feedback. However, evidence on whether this approach improves outcomes in real-world emergency medical service (EMS) systems is still limited.
Read more
This study aims to compare the effectiveness of TA-CPR with conventional DA-CPR in adult patients with suspected non-traumatic OHCA. The study is designed as a pragmatic cluster-randomized controlled trial conducted within a hospital-based EMS system in Bangkok, Thailand. Instead of randomizing individual patients, the CPR instruction protocol is assigned by month (cluster randomization). During each month, all eligible patients receive either the TA-CPR protocol or the DA-CPR protocol.
In both groups, CPR instructions are first provided through voice communication to avoid delaying the start of chest compressions. In the TA-CPR group, responders may switch to video communication if it is feasible, depending on factors such as the caller's device capability and the availability of another person to hold the camera. In the DA-CPR group, only voice communication is used throughout.
The study includes adult patients (aged 18 years or older) with suspected non-traumatic cardiac arrest who are managed by the participating EMS unit. Patients are excluded if resuscitation is declined, if the location is unsafe, if the cardiac arrest is witnessed by EMS personnel, or if communication barriers prevent CPR instructions.
The primary outcome of the study is the proportion of patients who receive bystander CPR before EMS arrival. Secondary outcomes include whether bystanders continue chest compressions until EMS arrives, how well responders follow the assigned protocol, and selected patient outcomes such as return of spontaneous circulation and survival.
Data are collected from an EMS cardiac arrest registry and hospital medical records. Audio recordings of dispatcher and responder communications are reviewed to assess adherence to the study protocols. The results of this study will help determine whether adding video communication to dispatcher-assisted CPR provides additional benefit in real-world EMS settings and inform future implementation of telemedicine in emergency care systems.
- Being tested
- Telemedicine-Assisted CPR (TA-CPR), Dispatcher-Assisted CPR (DA-CPR)
- Keywords
- Dispatcher-Assisted CPR, Telemedicine, Video-Assisted CPR, Out-of-Hospital Cardiac Arrest (OHCA), Emergency Medical Services (EMS), Bystander CPR
- Medical subject headings
- Out-of-Hospital Cardiac Arrest
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Telemedicine-Assisted CPR (TA-CPR)Behavioural
Participants receive dispatcher or EMS-guided cardiopulmonary resuscitation (CPR) with an initial audio-based instruction followed by real-time video communication when feasible. Video guidance is implemented based on device capability, connectivity, and availability of an additional bystander to assist with video transmission. If video is not feasible, CPR instructions continue via audio.
Dispatcher-Assisted CPR (DA-CPR)Behavioural
Participants receive conventional dispatcher-assisted CPR instructions delivered exclusively via audio (telephone communication) without the use of video support.
| Study group | Role | What they receive |
|---|---|---|
| Telemedicine-Assisted CPR (TA-CPR) | Experimental | Participants receive prearrival cardiopulmonary resuscitation (CPR) instructions provided by emergency medical service (EMS) personnel using a telemedicine-assisted approach. CPR instructions are initiated using audio (telephone) communication to avoid delays in chest compression initiation. Following initial instruction, EMS personnel assess the feasibility of establishing real-time video communication based on device capability, internet connectivity, and the availability of an additional bystander to assist with video transmission. When feasible, CPR guidance is continued with live video support to provide real-time visual feedback. If video communication cannot be established, CPR instructions continue via audio only. Receives: Behavioral: Telemedicine-Assisted CPR (TA-CPR) |
| Dispatcher-Assisted CPR (DA-CPR) | Active comparator | Participants receive conventional prearrival cardiopulmonary resuscitation (CPR) instructions provided by emergency medical service (EMS) personnel using audio-only (telephone) communication. CPR guidance is delivered continuously via voice without the use of video communication throughout the prehospital period. Receives: Behavioral: Dispatcher-Assisted CPR (DA-CPR) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Bystander CPR rate
Proportion of patients with suspected out-of-hospital cardiac arrest who receive cardiopulmonary resuscitation from a bystander prior to EMS arrival
Measured: From enrollment to the end of resuscitation at 1 day
Secondary outcomes (5)
Ongoing bystander CPR at EMS arrival
Proportion of patients receiving continuous chest compressions by bystanders at the time EMS arrives
Measured: From enrollment to the end of resuscitation at 1 day
Protocol compliance
Proportion of cases in which EMS personnel adhere to all required steps of the assigned CPR instruction protocol (including successful video use in TA-CPR when applicable)
Measured: From enrollment to the audit protocol at 4 weeks
Return of spontaneous circulation (ROSC) at emergency department
Return of spontaneous circulation (ROSC) at emergency department
Measured: From enrollment to the end of resuscitation at 1 day
Survival to hospital admission
Measured: During hospitalization (assessed up to 5 days)
Survival to hospital discharge
Measured: During hospitalization (assessed up to 24 weeks)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Apr 2026
- Study start1 Feb 2025
- Primary completion30 Sep 2025
- Study completion31 Dec 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Out-of-hospital Cardiac Arrest (OHCA)Studies 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
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 108 participants (actual)
Sponsor and investigators
- Lead sponsor
- Siriraj Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Sattha Riyapan, Siriraj Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07546474
- Sponsor's protocol ID
- SI821/2024
- Acronym
- TACTIC
- Status last verified
- Apr 2026
- First submitted
- 11 Apr 2026
- Last updated
- 22 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: De-identified individual participant data (IPD) underlying the results reported in this study, including demographic characteristics, prehospital variables, and clinical outcomes, will be made available to qualified researchers upon reasonable request. Data will be shared after removal of all personally identifiable information in accordance with applicable data protection regulations.
Publications
Lee SY, Song KJ, Shin SD, Hong KJ, Kim TH. Comparison of the effects of audio-instructed and video-instructed dispatcher-assisted cardiopulmonary resuscitation on resuscitation outcomes after out-of-hospital cardiac arrest. Resuscitation. 2020 Feb 1;147:12-20. doi: 10.1016/j.resuscitation.2019.12.004. Epub 2019 Dec 13.
PubMed 31843537Lin YY, Chiang WC, Hsieh MJ, Sun JT, Chang YC, Ma MH. Quality of audio-assisted versus video-assisted dispatcher-instructed bystander cardiopulmonary resuscitation: A systematic review and meta-analysis. Resuscitation. 2018 Feb;123:77-85. doi: 10.1016/j.resuscitation.2017.12.010. Epub 2017 Dec 12.
PubMed 29242057Nikolaou N, Dainty KN, Couper K, Morley P, Tijssen J, Vaillancourt C; International Liaison Committee on Resuscitation's (ILCOR) Basic Life Support and Pediatric Task Forces. A systematic review and meta-analysis of the effect of dispatcher-assisted CPR on outcomes from sudden cardiac arrest in adults and children. Resuscitation. 2019 May;138:82-105. doi: 10.1016/j.resuscitation.2019.02.035. Epub 2019 Mar 8.
PubMed 30853623
Study at a glance
From the registry record, last updated by the sponsor on 22 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Telemedicine-Assisted vs Conventional Telephone Instruction in Cardiopulmonary Resuscitation
- ClinicalTrials.gov ID
- NCT07546474
- Acronym / sponsor ID
- TACTIC / SI821/2024
- Keywords
- Dispatcher-Assisted CPR, Telemedicine, Video-Assisted CPR, Out-of-Hospital Cardiac Arrest (OHCA), Emergency Medical Services (EMS), Bystander CPR
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 108 participants (actual)
- Lead sponsor
- Siriraj HospitalUniversity, hospital or other
- Study start
- 1 Feb 2025 (actual)
- Primary completion
- 30 Sep 2025 (actual)
- Study completion
- 31 Dec 2025 (actual)
- First posted
- 22 Apr 2026 (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.
Out-of-hospital cardiac arrest (OHCA) is a life-threatening emergency where early cardiopulmonary resuscitation (CPR) by bystanders can significantly improve survival. Emergency dispatchers often guide bystanders to perform CPR over the phone, a method known as dispatcher-assisted CPR (DA-CPR). While this approach has increased bystander CPR rates worldwide, it relies on voice communication only, which may limit the dispatcher's ability to assess the situation and guide CPR effectively.
With advances in telecommunication technology, video-based communication has become more widely available. Telemedicine-assisted CPR (TA-CPR) allows dispatchers or emergency medical providers to see the patient and the rescuer through a live video call, potentially improving CPR performance by providing real-time visual feedback. However, evidence on whether this approach improves outcomes in real-world emergency medical service (EMS) systems is still limited.
This study aims to compare the effectiveness of TA-CPR with conventional DA-CPR in adult patients with suspected non-traumatic OHCA. The study is designed as a pragmatic cluster-randomized controlled trial conducted within a hospital-based EMS system in Bangkok, Thailand. Instead of randomizing individual patients, the CPR instruction protocol is assigned by month (cluster randomization). During each month, all eligible patients receive either the TA-CPR protocol or the DA-CPR protocol.
In both groups, CPR instructions are first provided through voice communication to avoid delaying the start of chest compressions. In the TA-CPR group, responders may switch to video communication if it is feasible, depending on factors such as the caller's device capability and the availability of another person to hold the camera. In the DA-CPR group, only voice communication is used throughout.
The study includes adult patients (aged 18 years or older) with suspected non-traumatic cardiac arrest who are managed by the participating EMS unit. Patients are excluded if resuscitation is declined, if the location is unsafe, if the cardiac arrest is witnessed by EMS personnel, or if communication barriers prevent CPR instructions.
The primary outcome of the study is the proportion of patients who receive bystander CPR before EMS arrival. Secondary outcomes include whether bystanders continue chest compressions until EMS arrives, how well responders follow the assigned protocol, and selected patient outcomes such as return of spontaneous circulation and survival.
Data are collected from an EMS cardiac arrest registry and hospital medical records. Audio recordings of dispatcher and responder communications are reviewed to assess adherence to the study protocols. The results of this study will help determine whether adding video communication to dispatcher-assisted CPR provides additional benefit in real-world EMS settings and inform future implementation of telemedicine in emergency care systems.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Telemedicine-Assisted CPR (TA-CPR) | Experimental | Behavioral: Telemedicine-Assisted CPR (TA-CPR)Participants receive prearrival cardiopulmonary resuscitation (CPR) instructions provided by emergency medical service (EMS) personnel using a telemedicine-assisted approach. CPR instructions are initiated using audio (telephone) communication to avoid delays in chest compression initiation. Following initial instruction, EMS personnel assess the feasibility of establishing real-time video communication based on device capability, internet connectivity, and the availability of an additional bystander to assist with video transmission. When feasible, CPR guidance is continued with live video support to provide real-time visual feedback. If video communication cannot be established, CPR instructions continue via audio only. |
| Dispatcher-Assisted CPR (DA-CPR) | Active comparator | Behavioral: Dispatcher-Assisted CPR (DA-CPR)Participants receive conventional prearrival cardiopulmonary resuscitation (CPR) instructions provided by emergency medical service (EMS) personnel using audio-only (telephone) communication. CPR guidance is delivered continuously via voice without the use of video communication throughout the prehospital period. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Adult patients aged ≥18 years
- Suspected non-traumatic out-of-hospital cardiac arrest
- Managed by the participating advanced life support (ALS) EMS unit
Key exclusion criteria (5 listed)
- Resuscitation declined by patient's relatives
- Cardiac arrest occurring in unsafe or inappropriate locations for EMS intervention
- EMS-witnessed cardiac arrest
- Inability of bystander to communicate in Thai
- Cases where ALS unit is not directly dispatched to the scene
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Telemedicine-Assisted CPR (TA-CPR)Participants receive dispatcher or EMS-guided cardiopulmonary resuscitation (CPR) with an initial audio-based instruction followed by real-time video communication when feasible. Video guidance is implemented based on device capability, connectivity, and availability of an additional bystander to assist with video transmission. If video is not feasible, CPR instructions continue via audio. | Behavioural | Telemedicine-Assisted CPR (TA-CPR) |
| Dispatcher-Assisted CPR (DA-CPR)Participants receive conventional dispatcher-assisted CPR instructions delivered exclusively via audio (telephone communication) without the use of video support. | Behavioural | Dispatcher-Assisted CPR (DA-CPR) |
Primary outcome
Bystander CPR rate
Time frame: From enrollment to the end of resuscitation at 1 day
Proportion of patients with suspected out-of-hospital cardiac arrest who receive cardiopulmonary resuscitation from a bystander prior to EMS arrival
5 secondary outcomes
Ongoing bystander CPR at EMS arrival
Time frame: From enrollment to the end of resuscitation at 1 day
Protocol compliance
Time frame: From enrollment to the audit protocol at 4 weeks
Return of spontaneous circulation (ROSC) at emergency department
Time frame: From enrollment to the end of resuscitation at 1 day
Survival to hospital admission
Time frame: During hospitalization (assessed up to 5 days)
Survival to hospital discharge
Time frame: During hospitalization (assessed up to 24 weeks)
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 22 Apr 2026.
- Results publication: PubMed 31843537Lee SY, Song KJ, Shin SD, Hong KJ, Kim TH. Comparison of the effects of audio-instructed and video-instructed dispatcher-assisted cardiopulmonary resuscitation on resuscitation outcomes after out-of-hospital cardiac arrest. Resuscitation. 2020 Feb 1;147:12-20. doi: 10.1016/j.resuscitation.2019.12.004. Epub 2019 Dec 13.
- Results publication: PubMed 29242057Lin YY, Chiang WC, Hsieh MJ, Sun JT, Chang YC, Ma MH. Quality of audio-assisted versus video-assisted dispatcher-instructed bystander cardiopulmonary resuscitation: A systematic review and meta-analysis. Resuscitation. 2018 Feb;123:77-85. doi: 10.1016/j.resuscitation.2017.12.010. Epub 2017 Dec 12.
- Results publication: PubMed 30853623Nikolaou N, Dainty KN, Couper K, Morley P, Tijssen J, Vaillancourt C; International Liaison Committee on Resuscitation's (ILCOR) Basic Life Support and Pediatric Task Forces. A systematic review and meta-analysis of the effect of dispatcher-assisted CPR on outcomes from sudden cardiac arrest in adults and children. Resuscitation. 2019 May;138:82-105. doi: 10.1016/j.resuscitation.2019.02.035. Epub 2019 Mar 8.
- Individual participant dataSharing planned: Yes. De-identified individual participant data (IPD) underlying the results reported in this study, including demographic characteristics, prehospital variables, and clinical outcomes, will be made available to qualified researchers upon reasonable request. Data will be shared after removal of all personally identifiable information in accordance with applicable data protection regulations.
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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.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Telemedicine-Assisted CPR (TA-CPR) and Dispatcher-Assisted CPR (DA-CPR) in people with Out-of-hospital Cardiac Arrest (OHCA) and Emergency Medical Services, run by Siriraj Hospital at 1 site in Thailand.
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 3 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 22 Apr 2026. 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 Thailand. 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?
Bystander CPR rate (time frame: From enrollment to the end of resuscitation at 1 day). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07546474, which also lists 3 linked publications.
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 22 Apr 2026.