TECHNOLOGY OF CPR STRATEGIES: A RANDOMIZED TRIAL

这项研究的长期目标是确定一个 简化形式的心肺复苏指导(涉及 仅使用胸部按压)由调度员提供给 打电话报告潜在的心脏骤停的人，提供了更大的 存活率高于ABC说明，涉及呼吸道、呼吸和胸部 压缩。一个肯定的答案是：1)直接证明旁观者心肺复苏 影响存活率，从而解决了这样的问题 观察到旁观者心肺复苏与提高的存活率之间的关联是 与相同的第三变量的共同关联的结果。2)它 将通过简化和缩短来减轻调度员的负担 与呼叫者的互动，同时提供更好的结果。以及，3)它 可能会对公众健康产生影响，而不是 艾滋病的传播。这项研究将是一项随机试验， 注册时间超过6.5年(1.75年将在 本申请的资助日期)按如下方式进行： 每个请求紧急医疗救助的呼叫调度员 被诊断为心脏骤停，而心肺复苏没有进行或正在进行 启动将代表着试验中随机化的一个插曲。 在连接到每个调度员的微型计算机上的一次击键 电台的结果是将该集随机化为指令 仅涉及胸部按压或涉及 心肺复苏术中传统的呼吸道、呼吸和胸部按压指导。 对微型计算机进行编程，以便于调度员在 到特定的指令集(这个过程现在已经测试过了 超过五年)。 随后，对护理现场报告进行审查以确定 实际上处于心脏骤停状态的患者。研究患者包括 那些心脏骤停的患者，他们的发作是 随机化。结果衡量标准是存活率--定义为活着出院 从医院出来的，没有严重的神经共病。然而， 因为心脏骤停的存活率不是在脑室发现的 据普遍报道，纤维颤动非常糟糕，是一个关键 二次分析将比较被发现为 室颤。初步分析将比较两国的存活率 所有随机研究的患者。

The long-term objective of this research is to determine whether a simplified form of cardiopulmonary resuscitation instruction (involving the use of chest compressions only) provided by the dispatcher to the person calling to report a potential cardiac arrest, provides greater survival rates than ABC instructions involving airway, breathing and chest compression. A positive answer would: 1) prove that bystander CPR directly effects survival rates thus resolving the question of whether or not the observed association between bystander CPR and improved survival rates is the consequence of a common association with same third variable. 2) It would reduce the burden on the dispatcher by simplifying and shortening the interaction with the caller while providing better outcome. And, 3) it could have public health implications vis-a-vis the concern about transmission of AIDS. The study would be a randomized trial, with enrollment extending over 6.5 years (1.75 years will be completed by the date of funding for this application) conducted as follows: Each call requesting emergency medical aid for what the dispatcher diagnoses as cardiac arrest and for which CPR is not in progress or about to be initiated would represent an episode for randomization in the trial. A single key stroke on a microcomputer attached to each dispatcher's station results in randomization of that episode either to instructions involving chest compression only or to instructions involving the traditional airway, breathing and chest compression instruction for CPR. The microcomputer is programmed to facilitate the dispatcher with regard to the specific instruction set (a process that has been tested now for over five years). Subsequently, the paramedic field reports are reviewed to determine those patients who were actually in cardiac arrest. Study patients consist of those patients who were in cardiac arrest and whose episodes were randomized. The outcome measure is survival-defined as discharged alive from the hospital without serious neurological comorbidity. However, because survival from cardiac arrest for patients not found in ventricular fibrillation has been universally reported to be very poor, a key secondary analysis will compare survival in patients who are found in ventricular fibrillation. The primary analysis will compare survival in all randomized study patients.