The Challenge
Each year, more than 25,000 Australians experience out-of-hospital cardiac arrests (OHCA), sudden events where the heart unexpectedly stops beating. Despite advances in emergency medical services, the survival rate remains alarmingly low, approximately 10%, based on figures from Europe and the United States.
Project Overview
- The EVIDENCE trial examines whether expedited transport to the hospital improves survival compared to extended on-scene resuscitation for OHCA patients. Up until now, there have been no high-quality studies on this topic. Additionally, this study will assess survival outcomes and the cardiac arrest system in Sydney and NSW.
- The PRE-CARE trial explores the feasibility of providing ECMO (Extra Corporeal Membrane Oxygenation) in pre-hospital settings. ECMO, a mini heart-lung bypass machine, is crucial for the best outcomes but typically available only during business hours at limited sites. The PRE-CARE trial aims to start ECMO at the scene, potentially reducing the critical time from cardiac arrest to the provision of ECMO support with pre-hospital extracorporeal cardiopulmonary resuscitation (ECPR) to ensure the very best outcomes. Pre-hospital ECMO is utilised in several countries worldwide but remains cutting-edge in cardiac arrest management.
Measuring Impact
Hearts and Minds measures its impact against six core categories as developed by the Association of Australian Medical Research Institutes. Key highlights include:
Advancing Knowledge
- Collaborations: These trials involve multiple centres and strong partnerships, including Ambulance services nationally, NHMRC Clinical Trials Centre and various international collaborations.
- Presentations: Findings will be shared at major international conferences like Critical Care Reviews.
- Awareness: Media coverage has included news segments and articles on both the EVIDENCE trial and PRE-CARE trial, increasing public and community awareness.
Research Capacity Building
- Diverse Team: More than half of the research staff are women, with a team comprised of emergency physicians, clinical nurse consultants, rotating emergency medicine registrar and research nurses from a range of cultural and religious backgrounds.
Health Impacts
- Improved Outcomes: Both trials have the potential to significantly improve patient outcomes, possibly reducing mortality rates and disability.
Economic Impacts
- Additional funding: Lead researchers have secured a grant for a health economics review of ECPR/prehospital ECPR and further funding from NSW Health in support of the EVIDENCE trial.
Social Impacts
- Inclusive Trials: The PRE-CARE trial extends ECMO availability to patients in broader geographical areas, including Sydney's western suburbs, ensuring equitable access to life-saving treatment.
Informing Decisions
- ECMO Implementation: The PRE-CARE trial tests ECMO's effectiveness in pre-hospital settings, guiding future research and clinical practices.
- Best Practices: These studies will provide valuable insights into the most effective methods for treating OHCA, influencing both pre-hospital and in-hospital care practices.
These trials have the potential to revolutionise emergency cardiac care, significantly improving survival rates and outcomes for Australians who experience out-of-hospital cardiac arrest.
Funding support from Hearts and Minds Investments, as nominated by Core Fund Manager, Regal Funds. This content was last updated in July 2024, for further information visit RPA Green Light Institute for Emergency Care.
