TECHNOLOGY OF CPR STRATEGIES: A RANDOMIZED TRIAL

这项研究的长期目标是确定 简化心肺复苏术指导（包括 仅使用胸部按压）由调度员提供给 一个人打电话报告潜在的心脏骤停，提供更大的 生存率高于涉及气道、呼吸和胸部的ABC指导 压缩一个肯定的答案将：1）证明旁观者心肺复苏术直接 影响存活率，从而解决了 观察到旁观者心肺复苏术和提高生存率之间的相关性， 与同一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。（3）它 可能会对公众健康产生影响， 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年将由 本申请的资助日期）进行如下： 每个请求紧急医疗救助的电话 诊断为心脏骤停，心肺复苏术未进行或 将代表试验中随机化的一次发作。 每个调度员的电脑上的一个按键 设定导致事件随机化， 仅涉及胸部按压或涉及 传统的气道、呼吸和胸部按压指导。 微型计算机被编程以方便调度员关于 到特定的指令集（现在已经测试过的过程， 五年以上）。 随后，对护理人员现场报告进行审查， 心脏骤停的病人研究患者包括 那些心脏骤停的病人， 随机的结果的衡量标准是生存率-定义为活着出院 没有严重的神经系统并发症然而，在这方面， 因为心脏骤停患者的存活率在心室 据报道，纤维性颤动普遍很差，这是一个关键问题。 次要分析将比较以下患者的生存率： 心室颤动主要分析将比较 所有随机化研究患者。

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.