International recommendations stress on the importance of no flow time reduction in cardiac arrest management. In fact, no flow time is an independent factor of morbidity and mortality. In France, cardiac arrests are treated by first responders (including emergency nurses) before the arrival of a mobile intensive care unit. Those first responders use bag-valve-mask for ventilation and therefore practice conventional CPR (30 chest compression / 2 ventilation rhythm). Laryngeal tube is a safe and efficient device in cardiac arrest ventilation. The purpose of our study is to compare the no flow time between two strategies of out of hospital cardiac arrest management by first responders: conventional CPR with bag-valve-mask ventilation vs. compression only CPR with Laryngeal Tube ventilation.
Multicentric, prospective, controlled, randomized study with parallel groups in single blind. Patients will be included in chronological periods to avoid selection biais (one month with the first medical device the next month with the other one). The determination of these periods will be centralized. The emergency vehicles will be supplied sufficiently with devices. This design has been chosen in order to answer to the emergency problem. Patients will be included and ventilated by paramedical staff (first responders) before medical staff (Mobile Intensive Care Unit) intervention. Complete detailed information will be given to the patient or to the family and consent asked. The comparison of no flow time between the two strategies in out of hospital cardiac arrest will be the following : A : ventilation by bag valve mask and interrupted chest compression B : ventilation by laryngeal tube and continuous chest compression
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
84
Comparison of no flow time between two strategies in out of hospital cardiac arrest
Comparison of no flow time between two strategies in out of hospital cardiac arrest
SDIS
Fontaine, Isere, France
Samu Smur
Grenoble, Isere, France
comparison of no flow time between two strategies
group A : ventilation by bag valve mask and interrupted chest compression group B : ventilation by laryngeal tube and continuous chest compression outcome measure : time of no flow during Resuscitation by trained paramedical staff in out of hospital cardiac arrest
Time frame: arrival of paramedical staff T0
qualitative observation of laryngeal tube use for ventilation of patients in cardiac arrest
No flow proportion during resuscitation by paramedical staff after emergency training
Time frame: during cardiac arrest at T0
qualitative observation of laryngeal tube use for ventilation of patients in cardiac arrest
no flow proportion on total resuscitation duration
Time frame: during cardiac arrest at T0
qualitative observation of laryngeal tube use for ventilation of patients in cardiac arrest
number of failure installation after 2 tests
Time frame: during cardiac arrest at T0
qualitative observation of laryngeal tube use for ventilation of patients in cardiac arrest
Time of device installation
Time frame: during cardiac arrest at T0
qualitative observation of laryngeal tube use for ventilation of patients in cardiac arrest
chest expansion during insuflation (yes/no)
Time frame: during cardiac arrest at T0
qualitative observation of laryngeal tube use for ventilation of patients in cardiac arrest
Mortality : spontaneous cardiac activity recovery, hospital admission, reanimation service or hospital exit date, survival at 28 days , CPC evaluation for patients alive
Time frame: during cardiac arrest at T0
qualitative observation of laryngeal tube use for ventilation of patients in cardiac arrest
incident during ventilation : obstruction number of manipulations to optimize ventilation
Time frame: during cardiac arrest at T0
qualitative observation of laryngeal tube use for ventilation of patients in cardiac arrest
ETCO2
Time frame: during cardiac arrest at T0
qualitative observation of laryngeal tube use for ventilation of patients in cardiac arrest
Number of external electric shocks
Time frame: during cardiac arrest at T0
qualitative observation of laryngeal tube use for ventilation of patients in cardiac arrest
degradation due to technical manipulations
Time frame: during cardiac arrest a T0
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