Clinical Research Directory

Drone Delivery of Automated External Defibrillators to Lay Users (DAEDALUS): A Proof of Concept Study

Summary in non-technical language Aim(s) of the research We are working on a way to use drones to deliver Automated External Defibrillators (AEDs) - devices that help restart a person's heart by giving it an electric shock. These drones will bring AEDs to people helping someone having a cardiac arrest outside of a hospital setting. Our goal is to make sure everything works smoothly, from the time the emergency call is made to when the AED helps the patient. This research is important because it will help us find out the best process to deliver AEDs by drone and what challenges might come up. Background to the research A cardiac arrest happens when a person's heart suddenly stops, which stops blood from getting to their organs. Acting fast is very important. In the UK, less than 10% of people survive cardiac arrests because it often takes too long to get them the help they need. AEDs can save lives by restarting the heart, but they need to get to the patient quickly. Design and methods used This project has two main parts: 1. Creating the drone delivery process: We will develop a system to get an AED to someone in need, from the moment someone calls 999 to when the AED reaches the patient. This involves working with emergency services, Air Traffic Control, and drone operators. We will test how this works using testing sessions with training manikins at Redhill Aerodrome over four days. We will measure how long things take and gather feedback to improve the process after each session. 2. Interviews: We will talk to people who have been involved in a cardiac arrest, like patients, family members, carers, or members of the public who have helped someone having a cardiac arrest. We will also speak to people who have no experience of cardiac arrests, to understand how they feel about drones delivering AEDs. We want to know if people think this is a good idea and what challenges or concerns they might have. Patient and Public Involvement A group of patients, family members/carers, and members of the public will help us check that our plans are practical and clear and will provide feedback throughout the study. They will also help review the results and create materials to share with the public. We will provide training, so everyone feels comfortable contributing. Dissemination We will keep everyone updated through a newsletter on our website and social media. The public involvement group will review and contribute to these updates. We will also hold public events and share our findings in reports, journal articles, conferences and webinars, so a wide range of people can access the results.

Early Double Sequential Defibrillation in Out of Hospital Cardiac Arrest

Some of the patients affected by Out-of-hospital cardiac arrest (OHCA) with ventricular fibrillation (VF)/ventricular tachycardia (VT) do not respond to initial defibrillation. The survival decreases with number of defibrillations required to terminate VF/VT. In 2022, one prospective cluster randomized trial showed increased survival among (OHCA) patients in refractory VF using Double Sequential Defibrillation (DSD). If DSD can increase survival among all patients in VF that dont respond to one defibrillation, i.e. before it has become refractory is not known. The aim of this trial is to assess survival with a double defibrillation strategy initiated as soon as possible among patients with Out of Hospital Cardiac Arrest with initial shockable rhythm and at least one failed standard defibrillation, compared with continued resuscitation using standard defibrillation.

Timing for Computed Tomography and Post-Resuscitation Care on Short-Term Outcomes in Out-of-Hospital Cardiac Arrest

This retrospective multicenter study investigates the association between the timing of computed tomography (CT) scans and short-term outcomes in adult non-traumatic out-of-hospital cardiac arrest (OHCA) patients who achieved return of spontaneous circulation (ROSC). The study includes cases from January 1, 2016, to August 31, 2024, across six branches of National Taiwan University Hospital. Data collected include demographics, Utstein variables, emergency department (ED) interventions and their timing. Primary outcomes are survival to admission, and 1-day, 3-day, and 7-day survival. Secondary outcomes focus on the timing and sequence of CT imaging and other interventions in relation to short-term prognosis and ED length of stay. The study aims to explore whether earlier CT utilization can improve outcomes in the post-resuscitation phase of care.

Artificial Intelligence Cerebral Gray-white Matter Ratio Module Usage in Hsinchu District Hsinchu District Using an Artificial Intelligence Cerebral Gray-white Matter Ratio Module

This study aims to establish an electronic medical record and imaging database for out-of-hospital cardiac arrest (OHCA) patients at NTUH Hsinchu Branch. Leveraging an AI deep learning model and an automated brain gray-white matter analysis system developed at NTUH, the research seeks to validate these tools externally. By integrating electronic medical records and brain imaging data, the project strives to enhance the accuracy of prognostic assessments, supporting physicians and families in decision-making for post-cardiac arrest care. Validation at Hsinchu Branch will assess the model's reliability across diverse medical settings and patient populations, optimizing its applicability and accuracy.

Skeletal Muscle Mass on Prognosis and Recovery in Clinical Trial

The objective of this research project is to develop an automated muscle mass measurement system based on computed tomography (CT) images using deep learning and artificial intelligence, and to construct a prognostic prediction model for patients who have experienced cardiac arrest and undergone resuscitation. The model will be validated using multicenter registry data and medical imaging. Furthermore, a clinical trial involving core muscle rehabilitation for post-resuscitation patients will be conducted to evaluate both short-term and long-term outcomes, aiming to comprehensively understand the impact of muscle mass on the prognosis of patients after cardiac arrest.

Ambulance Clinicians' Experiences of Attending OHCA in Children

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.

Rapid Prehospital ACcess to ECPR in Prague

A prospective pilot feasibility study of prehospital ECPR in patients with refractory OHCA

Cardiac Arrest Bundle of cARE Trial

An out-of-hospital cardiac arrest is a sudden event where the heart stops beating and a person becomes unresponsive. During this event, vital organs in the body receive no blood flow, causing them to shut down. Without intervention to restart the heart, a person effectively dies. In the UK, around 60,000 people experience cardiac arrests each year, with most occurring at home. Despite prompt emergency service response, survival rates are typically low. There is technology available that has the potential to improve survival rates for out-of-hospital cardiac arrests. The intervention involves three devices used together: head-up position CPR (Elegard), active compression-decompression mechanical CPR (Lucas-3), and the Impedance Threshold device (Resqpod-16). When combined, these devices can enhance blood flow during resuscitation, potentially leading to improved initial resuscitation rates and higher rates of survival with normal brain function after a cardiac arrest. A pilot study is planned to test the feasibility of using these devices. The results will inform the design of a larger study to determine if this technology can indeed improve survival rates in out-of-hospital cardiac arrests.