CompletedNot Applicable

Telemedicine-Assisted vs Conventional Telephone Instruction in Cardiopulmonary Resuscitation

Thailand108 participantsStarted 2025-02-01

Plain-language 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). 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.

Who can participate

Age range

18 Years

Sex

ALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: * Adult patients aged ≥18 years * Suspected non-traumatic out-of-hospital cardiac arrest * Managed by the participating advanced life support (ALS) EMS unit Exclusion Criteria: * 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

Questions worth asking your doctor

Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.

1This trial compared telemedicine video guidance to regular phone instructions for teaching bystanders CPR during a cardiac arrest emergency — if someone in my household has a high cardiac arrest risk, does my doctor think telemedicine-assisted dispatcher guidance could realistically make a difference in my specific situation?
2Since this trial has already been completed and was measuring whether bystander CPR rates improved with video versus phone guidance, has my doctor seen any of the results, and what do those findings suggest about how I or my family members might be better supported in an emergency?
3This study involved out-of-hospital cardiac arrest and emergency medical services — given my condition, should I be talking with my care team about creating a specific emergency action plan for home that accounts for how long it might take EMS to arrive?
4Because this was a Phase NA study focused on dispatcher-guided CPR instruction rather than a medical treatment, should I be asking about CPR training courses my family and I could take now, rather than relying solely on emergency dispatcher guidance?
5If telemedicine tools can help untrained bystanders perform CPR more effectively during an OHCA, should my doctor and I discuss whether my local emergency services already use this kind of video-assisted dispatch technology, so I know what to expect if an emergency happens at home?

Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.

Questions for the trial coordinator

The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.

1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?

A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.

What they're measuring

Bystander CPR rate

Timeframe: From enrollment to the end of resuscitation at 1 day

Trial details

NCT IDNCT07546474

SponsorSiriraj Hospital

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2025-09-30

View on ClinicalTrials.gov More Out-of-hospital Cardiac Arrest (OHCA) trials