Cardiac Arrest Bundle of Care Trial Using Head-Up CPR, Active Compression-Decompression CPR, and Impedance Threshold Device

What this Trial Is About

Out-of-hospital cardiac arrest (OOHCA) is a sudden event where the heart stops beating, causing vital organs to lose blood flow and shut down. In the UK, about 60,000 people experience OOHCA annually, with survival rates remaining low despite emergency services. Researchers are studying whether a combination of three devices can improve blood flow during resuscitation and increase survival rates with good brain function after cardiac arrest. The study compares usual care with a "bundle of care" approach that uses three devices together: head-up position CPR (Elegard), active compression-decompression mechanical CPR (Lucas-3), and an impedance threshold device (Resqpod-16). In the intervention group, emergency teams will apply these devices along with standard CPR, including placing the impedance threshold device on the airway, activating the head elevation device after 2 minutes of CPR, and possibly intubating if needed. Resuscitation continues for at least 30 minutes or until the heart restarts. The control group receives standard CPR without these devices. Participants will be monitored throughout resuscitation, with assessments including cardiac rhythms, signs of life during CPR, carbon dioxide levels, return of spontaneous circulation, survival to hospital handover, and neurological outcomes at 30 days using the modified Rankin Scale. The study will also evaluate the feasibility of using the device bundle and training emergency staff. Participation lasts through the emergency event and includes follow-up up to 30 days for survival and neurological status.

Cardiac Arrest Bundle of cARE Trial