The goal of this randomized controlled trial is to compare prehospital ventilation strategies in out-of-hospital cardiac arrest. The intervention group is automatic ventilation and the control group is manual ventilation. The main questions it aims to answer are: 1. How does automatic ventilation affect OHCA patients' survival and prognosis comparing to manual ventilation. 2. What are the differences on resuscitation qualities between automatic ventilation and manual ventilation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
514
The FDA-approved device used is "Meditech" MICROVENT RESUSCITATOR, which is connected to the endotracheal tube, supraglottic airway or tracheostomy tube. It is powered by the airflow from the oxygen tank and provides ventilation in fixed interval. It has a pressure valve which will release the pressure once the airway pressure exceeds its threshold. In the current study, the threshold is set at 60 mmH2O. The tidal volume is set at 500-600 ml.
The adult size bag-valve mask is connected to the endotracheal tube, supraglottic airway or tracheostomy tube. The interval, pressure and volume of the ventilation is controlled by the emergency medical technicians.
National Taiwan University Hospital Hsinchu Branch
Hsinchu, Taiwan
RECRUITINGThe percentage of any return of spontaneous circulation (ROSC)
The patient achieved ROSC in prehospital or inhospital resuscitation.
Time frame: 2 hours
The percentage of sustained ROSC in 24 hours
The patient survives for 24 hours after arriving the hospital.
Time frame: up to 24 hours
The percentage of survival to hospital discharge
The patient survives to discharge from the hospital.
Time frame: up to 90 days
The percentage of favorable neurological outcome after discharge
The patient survives to discharge from the hospital with Cerebral Performance Categories Scale 1 or 2.
Time frame: up to 90 days
Chest compression fraction
The chest compression fraction during prehospital resuscitation recorded by the monitor.
Time frame: up to 1 hour
The percentage of intravenous catheter placement
Whether the patient has an IV catheter placed in the prehospital setting.
Time frame: up to 1 hour
The percentage of epinephrine injection
Whether the patient has epinephrine injected in the prehospital setting.
Time frame: up to 1 hour
The satisfaction of emergency medical technician (EMT) during the dispatch
The outcome contained five questions: * More convenient to use * Shorter time required to complete ventilation (from advanced airway placement to the start of ventilation) * Smoother patient transport process * Ability to perform more emergency medical techniques * Overall satisfaction with the execution of emergency medical tasks The EMTs answer in the 5-level scale (highly disagree, disagree, neutral, agree, highly agree)
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Time frame: up to 5 hours
The percentage of pneumothorax
Unilateral, bilateral or tension pneumothorax which might be associated with the ventilation strategy.
Time frame: up to 3 days