Ambulance Clinicians' Experiences of Attending OHCA in Children
ConditionOut of Hospital Cardiac Arrest
Trial statusNot yet recruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
AgeNot listed
SponsorUniversity of Warwick
About this trial
This research will explore ambulance clinicians' experiences of attending out of hospital cardiac arrest (OHCA) incidents involving children.
OHCA occurs when the heart stops beating. This is a time critical emergency that requires immediate treatment to maximise the changes of survival. OHCA affecting children is rare, but when it happens it is vital that paramedics and other ambulance clinicians can respond and deliver high quality care.
Because OHCA in children is rare, ambulance clinicians attend these incidents infrequently. Some clinicians may only ever attend this type of incident once in their career. These incidents are technically challenging for ambulance clinicians, and highly stressful. Evidence from other setting suggests that clinicians may be ill-prepared to manage these events.
This research aims to understand how OHCA incidents involving children are currently managed, and to explore the views and experiences of ambulance clinicians with respect to attending OHCA incidents involving children.
By learning from what is currently being done, and from clinicians' experiences, the research team aims to develop recommendations for how the response to these patients, and the support provided to ambulance clinicians, could be improved.
The research team will review the records of patients under the age of 18 who have been treated for OHCA by one ambulance service over a four-year period. Data will be collected from these records to allow the care delivered to be compared to international guidelines, and to explore what factors might influence the delivery of this care.
The research will also involve a survey of ambulance clinicians working across the UK to understand their experiences, and how prepared they feel to attend these incidents. Finally, the research team will undertake interviews with clinicians who have been involved in the management of a child with OHCA and focus group discussions with specialist clinicians to allow us to learn from their experiences.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Patients attended by London Ambulance Service NHS Trust (LAS)
Incidents occurring between January 2021 and December 2024
Out of Hospital Cardiac Arrest recognised by LAS clinicians
Aged under 18 years at the time the incident occurred
Disqualifiers
New born patients who had not taken their first spontaneous breath before cardiac arrest was recognised
Incidents occurring outside of LAS' operational area (Greater London, UK)
Patients who have registered an NHS National Data Opt-Out
Ambulance clinician (including registered healthcare professionals and non-registered ambulance clinicians)
Trial population
The out of hospital cardiac arrest patient group will include patients aged \<18 years who were treated for out of hospital cardiac arrest by the London Ambulance Service NHS Trust. The survey, interview and focus group participants will be made up of ambulance clinicians employed in an NHS ambulance trust in the UK. * Survey participants in the recent exposure group will have recently attended an out of hospital cardiac arrest involving a child * Survey participants in the historic exposure group will have attended an out of hospital cardiac arrest involving a child \>12 months before the interview date * Focus group participants will be specialist critical care paramedics who attend out of hospital cardiac arrest incidents involving children
Trial design
Design model
Other
Time perspective
Retrospective
Treatments tested in this trial
Not listed
Trial groups
2,137 Participants
are grouped into 5 trial groupsGroup A: Out of hospital cardiac arrest patients
Group B: Survey participants
Group C: Interview participants (recent exposure)
Group D: Interview participants (historic exposure)
Group E: Focus group participants
Trial outcomes
Primary outcomes
1
Delivery of treatment in compliance with European Resuscitation Council Guidelines (work package one)
Proportion of cases that receive treatment that complies with European Paediatric Advanced Life Support guidelines.
Time frame
During cardiac arrest event (until handover at hospital or termination of resuscitation)2
Preparedness of clinicians to attend OHCA involving children (work package two)
Measured using self-reported Likert scale
Time frame
Baseline (defined as the date of survey completion)3
Clinician experiences of attending OHCA incidents involving children (work package three)
Measured through inductive thematic analysis of interviews and focus groups - data from interviews and focus groups will be combined and analysed thematically as one dataset to describe the overall experience of ambulance clinicians.
Time frame
Baseline (defined as the date of interview/focus group participation)Secondary outcomes
1
Proportion of participants with moderate or high levels of symptoms consistent with PTSD following attending an OHCA incident involving a child (work package two)
Post Traumatic Stress Disorder (PTSD) symptoms will be measured using the The Impact of Event Scale - Revised (IES-R) with reference to an attended OHCA incident involving a child. Participants will be classified as having moderate or high levels of symptoms consistent with PTSD if their mean score across all questions is 2 or higher.
Time frame
Baseline (defined as the date of survey completion)Sponsors and contacts
Click on the lead sponsor to view all of their trials.
University of Warwick
Lead sponsor
London Ambulance Service NHS Trust
Collaborator
Resuscitation Council UK
Collaborator
Source ClinicalTrials.gov
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