Clinical Research Directory

The OXY-VENT Study

Effective ventilation during cardiopulmonary resuscitation is essential but can be difficult to achieve consistently. Current practice relies on visible chest rise to guide ventilation volume, although this may not always accurately reflect the actual volume of air delivered. This study aims to determine whether a real-time ventilation feedback device, providing objective information on ventilation volume and air leakage, improves adherence to recommended ventilation volumes compared with standard ventilation without feedback. The study will focus on patients receiving CPR with a supraglottic airway and synchronous ventilation.

Physiology-directed Epinephrine Dosing in Pediatric Cardiac Arrest

This is a prospective, observational, multi-center cohort study of pediatric cardiac arrests. The purpose of this study is to evaluate the physiologic response to epinephrine as an outcome discriminator in pediatric in-hospital cardiac arrest (IHCA). In addition, the investigators will determine optimal epinephrine dosing strategies based on the initial physiologic response to epinephrine, and to develop machine learning (ML) algorithms to guide intra-arrest therapy.

The VENTOR Clinical Study

To evaluate the initial safety and effectiveness of the Ventor Airway System in providing short-term ventilation support in non-breathing subjects during cardiopulmonary resuscitation (CPR) and respiratory arrests.

Optimal Ventilation for Cardiac Arrest

Pediatric cardiac arrest is a life-threatening problem affecting \>15,000 hospitalized children each year. Less than half of these children survive to hospital discharge, and neurologic morbidity is common among survivors. The objective of this study is to evaluate the effectiveness of the OPTI-VENT bundle to improve survival to discharge with favorable neurological outcome (Pediatric Cerebral Performance Category Score 1-2 or no change from baseline) among children receiving at least 1 minute of CPR.

Integrated Near-Infrared Spectroscopy and Hemodynamic Monitoring for Cerebral Autoregulation in Post-Cardiac Arrest Care Neuroprognostication

Neurological outcome is the primary outcome for post-cardiac arrest patients. Hypoxic-ischemic brain injury is a key element in post-cardiac arrest syndrome, and remains the leading cause of mortality and morbidity in post-cardiac arrest patients. In patients with hypoxic-ischemic brain injury, impaired cerebral autoregulation makes cerebral blood flow highly vulnerable to blood pressure fluctuations, which might trigger secondary brain injuries. Although the pressure reactivity index (PRx) calculated via invasive intracranial pressure (ICP) monitoring is considered the gold standard for assessing cerebral autoregulation, its clinical application in post-cardiac arrest patients is limited due to invasive risks. Alternatively, cerebral near-infrared spectroscopy (NIRS) combined with hemodynamic monitoring offers a non-invasive approach to measure the cerebral oxygenation index (COx). However, its consistency with invasive methods and its accuracy in post-cardiac arrest care warrant further validation. The aim of this study is to assess cerebral autoregulation via COx calculated with NIRS and hemodynamic parameters in post-cardiac arrest patients, and to analyze the impact of this index on neurological outcomes. The further goal is to estimate optimal mean arterial pressure (MAPopt) and subsequently establish personalized post-resuscitation blood pressure targets.

Analysis of Life-threatening ARrhythMias After Acute Coronary Syndrome

Patients admitted with an acute coronary syndrome (ACS) are at increased risk of malignant cardiac arrhythmias (MA), such as sustained ventricular tachycardia and ventricular fibrillation. Therefore, patients with ST-elevation myocardial infarction (STEMI) are continuously monitored for a minimum of 24 hours after onset symptoms. Longer monitoring is advised in patients at intermediate to high risk of cardiac arrhythmias, however this risk stratification is not evidence based. Hospitalization, particularly in STEMI patients, is advised for a minimum of 48-72 hours. AMI care requires a substantial commitment of bed capacity and staff, resulting in high healthcare costs. In patients who have undergone acute PCI (such as STEMI patients or NSTEMI patients with persistent symptoms), monitoring is primarily aimed at early recognition of MA and signs of persistent or recurrent ischaemia after the intervention. In NSTEMI/UAP patients still awaiting invasive treatment, the emphasis lies on detecting increasing ischaemia in the as-yet untreated coronary vessel, as well as identifying arrhythmias that may arise as a result. The true incidence of MA cannot be precisely established due to heterogeneity in the literature, and moreover varies between patients with ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, and unstable angina pectoris, owing to differences in disease process and care pathway. A better understanding of the current incidence and risk of MA in patients with ACS may contribute to optimizing the monitoring of this patient group, thereby enabling more efficient use of hospital beds and healthcare staff. This prospective quality registry therefore aims to establish the current incidence of MA in ACS patients and to identify potential predictors of MA, while also taking into account other acute complications such as asystole and pulseless electrical activity (PEA).

Mind-body Resilience Program for Cardiac Arrest Survivors and Their Caregivers: Recovering Together After Cardiac Arrest

The purpose of this study is to pilot two resilience interventions for cardiac arrest survivors and their informal caregivers, Recovering Together after Cardiac Arrest 1 and Recovering Together after Cardiac Arrest 2 . The data the investigators gather in this study will be used to further refine the interventions.

The TTM and ASM Trial

Sudden cardiac arrest (SCA) remains one of the major challenges in clinical care. Although improvements in resuscitation quality have increased the likelihood of return of spontaneous circulation (ROSC), most patients still fail to survive to hospital discharge, and neurological injury is the leading determinant of poor outcome. Hypoxic-ischemic encephalopathy caused by global cerebral hypoxia during cardiac arrest is a key contributor to long-term disability, and even survivors often experience substantial functional impairment, placing a significant burden on families and society. Targeted temperature management (TTM) has long been regarded as a cornerstone neuroprotective strategy; however, TTM and TTM2 trials reported no significant neurological difference between lower and higher temperature targets. However, these studies predominantly enrolled patients with relatively mild illness severity, and multiple real-world observational cohorts suggest that, among more severely ill resuscitated patients, lower target temperatures may still confer benefit. Consequently, the optimal temperature strategy in higher-risk subgroups remains uncertain. Seizures are another common manifestation of brain injury after cardiac arrest, occurring in approximately 20-30% of resuscitated patients and contributing to secondary neurological damage. Earlier trials evaluating prophylactic anti-seizure medication (ASM) (thiopental or diazepam/magnesium) did not demonstrate neurological benefit; however, these studies primarily focused on neuroprotection rather than seizure prevention, leaving a substantial evidence gap. Patients with moderate to severe disease severity-those at the highest risk of both cerebral injury and seizure occurrence-have never been specifically studied to determine whether personalized temperature selection or early short-term prophylactic ASM (e.g., valproic acid or levetiracetam) may provide clinical benefit. Accordingly, identifying the most appropriate temperature target for higher-risk patients and determining whether short-term prophylactic antiepileptic therapy can reduce seizure-related injury represent important unresolved questions in post-resuscitation care. The aim of this study is to conduct a prospective, multicenter, randomized clinical trial to evaluate whether, among comatose patients with moderate to severe risk after ROSC, specific TTM temperature strategies combined with early short-term prophylactic ASM can reduce postresuscitation seizure incidence and improve neurological outcomes. By addressing a population underrepresented in prior clinical trials-those at highest risk and most likely to benefit-this study aims to generate clinically meaningful evidence to guide temperature selection and prophylactic ASM after cardiac arrest. Evaluating these interventions in combination may provide a more comprehensive understanding of whether they reduce seizure burden, mitigate brain injury, and improve functional recovery.

Critical Hyperacute Assessment Research On Neurobiomarker Kinetics in Acute Brain Injury

Traumatic brain injury (TBI) and other conditions that reduce blood flow to the brain - such as cardiac arrest (CA) - are life-threatening medical emergencies. When brain cells are damaged, they release specific proteins into the bloodstream. These proteins, called neurobiomarkers, can be measured in blood samples and may help doctors assess the severity of brain injury, guide treatment, and predict patient outcomes. A major gap in current knowledge is how these neurobiomarkers behave during the very first minutes and hours after injury - the so-called "hyperacute" phase - especially when patients are still being treated by paramedics or have just arrived at the emergency department (ED). It is not yet clear whether biomarker levels rise immediately at the moment of injury or gradually over time, and how quickly they can be reliably detected. The CHARON study investigates the time-dependent kinetics of key neurobiomarkers - including S100B, glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), neurofilament light chain (NFL), and Tau proteins- during the hyperacute phase of acute brain injury. In addition to these proteins, microRNAs, polar metabolites, and lipid metabolites are also examined as potential biomarkers. The study enrolls three groups of participants: * Patients with severe traumatic brain injury and/or polytrauma treated in the prehospital setting and admitted to the ED with T1 (highest priority) triage classification. * Patients with CA treated (resuscitated) in the prehospital setting. * Patients with severe traumatic brain injury enrolled at hospital (ED) admission. Serial blood samples are collected at multiple time points, beginning during prehospital care and continuing through the first 24 hours of hospital admission. No experimental treatments are given - all participants receive standard medical care. By analyzing biomarker concentration and kinetics across all three groups and correlating findings with neurological outcome at 30 days, the investigators aim to identify the most clinically effective neurobiomarkers for early diagnosis and prognosis of acute brain injury. The study is a prospective multi-center investigation conducted at emergency departments, intensive care units, and ambulance services across Hungary.

Cardiac REhabilitation COhort at the Medicine Campus DaVos to invEstigate Recovery

The RECOVER study, titled Cardiac Rehabilitation Cohort at the Medicine Campus Davos for Exploration of Recovery, is a prospective, non-interventional, monocentric cohort study conducted at the Hochgebirgsklinik Davos. The study is sponsored by Medicine Campus Davos AG and the Kühne Foundation, with an estimated start date in July 2025 and planned completion by December 2034, with the possibility of extension. The principal investigator of the study is PD Dr. David Niederseer from Hochgebirgsklinik Davos, who also represents the study. The research team includes co-investigators such as Prof. Dr. Stefan Blankenberg and Prof. Dr. Andreas Ziegler from Cardio-CARE, Medicine Campus Davos, as well as Dr. Jan Vontobel from Hochgebirgsklinik Davos. The study will enroll patients referred to Hochgebirgsklinik Davos for cardiac rehabilitation who provide informed consent. Cardiac rehabilitation is an evidence-based therapy for patients with heart disease, including those who have undergone cardiac procedures or surgeries. The primary objectives are to evaluate baseline patient characteristics, rehabilitation strategies, predictors of recovery, and clinical outcomes during and after rehabilitation. To support this, a detailed database and biobank will be established to allow for comprehensive phenotyping, extensive clinical assessments, and long-term follow-up. RECOVER seeks to gain translational insights into how patient-specific factors - such as genetics, plasma, digital and clinical biomarkers, and comorbidities - influence long-term clinical outcomes. The goal is to identify modifiable risk factors to optimize individualized therapeutic approaches in cardiac rehabilitation.

The Effect of Virtual Reality-Assisted Escape Room Experience

The aim of this study is to improve associate degree Dialysis Program students' Basic Life Support (BLS) knowledge and skills through a virtual reality (VR)-supported escape room intervention. Using a pretest-posttest experimental design, the study will include 60 students. The experimental group will receive VR-based gamified BLS training, while the control group will receive traditional BLS training. Data will be collected using a Descriptive Information Form, the Virtual Reality Attitude Scale, and the Game Experience Scale. The study is expected to provide evidence on the use of VR and gamification as experiential learning approaches in BLS education.

Effect of AED-optimized Telephone-assisted CPR Instructions on No-flow Time and Chest Compression Fraction

Out-of-hospital cardiac arrest (OHCA) remains a leading cause of mortality worldwide, with survival highly dependent on the immediate initiation of bystander cardiopulmonary resuscitation (CPR). Early recognition, prompt chest compressions, and rapid defibrillation are critical components of the chain of survival. Telephone-assisted CPR (T-CPR) provided by emergency dispatchers has been shown to significantly increase bystander intervention rates and improve outcomes. While the availability and use of automated external defibrillators (AEDs) further enhance survival, the optimal integration of AED use into dispatcher-guided, single-rescuer scenarios remains insufficiently studied. This prospective, randomized, controlled simulation study aims to evaluate the effect of modified telephone cardiopulmonary resuscitation (T-CPR) instructions optimized for automated external defibrillator (AED) use on no-flow time and chest compression fraction (CCF) during single-rescuer resuscitation. Participants are randomized to receive either standard T-CPR instructions or enhanced instructions focusing on minimizing interruptions in chest compressions and reducing time to first compression during AED use.

Nucleosome Monitoring Relevance for Outcome Prediction in Critically Ill Patients

NUROPI is a single-centre, prospective, non-interventional study in the Intensive Care Unit (ICU) of Erasme Hospital (Hôpital Universitaire de Bruxelles, Brussels, Belgium). Some critically ill patients get worse during the first days of their ICU stay. Identifying them early could allow faster escalation of care. Nucleosomes are fragments of DNA wrapped around proteins called histones. They are released into the blood when cells die or when white blood cells form neutrophil extracellular traps (NETs). High blood levels of nucleosomes may reflect inflammation, clotting activation and organ damage. This study will measure the H3.1 nucleosome in the blood of 1,000 consecutive adult ICU patients. The measurement uses a CE-marked laboratory test (Nu.Q® NETs, chemiluminescence immunoassay on the IDS-i10 analyser). No additional blood sample is taken for the study. H3.1 is measured on the leftover plasma of blood samples already drawn for routine care, at ICU admission, 6 hours, day 1, day 3 and day 7. Patient treatment is not changed. Patients, or their relatives or legal representative, receive an information notice and may refuse participation at any time. The main question is whether H3.1, alone or combined with routine ICU data, can identify patients at high risk of clinical deterioration within 72 hours of ICU admission. Other questions concern the link between H3.1 and mortality, organ dysfunction, and ICU treatments, and how H3.1 levels change during the first week.

Ventilation During CPR and Return of Spontaneous Circulation

During cardiopulmonary resuscitation (CPR), rescue breaths help move air into the lungs, but the amount of air delivered is rarely measured. This study examined whether the amount and rate of air delivered during CPR were related to the heart restarting its own circulation, called return of spontaneous circulation (ROSC).

Hand Position, CPR Quality and Rescuer Comfort

This randomized crossover simulation study will compare two hand positions used during chest compressions: interlocked fingers and non-interlocked hands placed one on top of the other. The study will evaluate whether the non-interlocked hand position is non-inferior to the interlocked-finger technique with regard to chest compression depth, and will compare the two techniques in terms of CPR quality, rescuer comfort, fatigue, pain or discomfort, and perceived hand-position stability.

Self-training and Resuscitation Techniques: Evaluation of the Performance and Impact on the Quality of Cardiopulmonary Resuscitation (CPR)

Cardiac arrest (CA) remains one of the leading causes of death worldwide, and its incidence continues to increase. The median survival rate following in-hospital cardiac arrest in France is 19%. In Europe, it ranges from 15% to 34%. Effective management of cardiac arrest is therefore essential to reduce the mortality rate associated with in-hospital cardiac arrest. However, cardiac arrest is a source of stress in conventional care settings. First, it is a life-threatening emergency in which the absence of effective management results in the patient's death. Furthermore, the occurrence of cardiac arrest in conventional hospital wards, particularly in pediatrics, is uncommon. Healthcare professionals are therefore not accustomed to encountering these situations, which may lead to apprehension, stress, and a lack of confidence in their skills when faced with cardiac arrest. In this context, maintaining skills is essential to ensure effective management of cardiac arrest. Providing open-access training in the workplace would make it possible to maintain a high level of proficiency over time while allowing healthcare professionals to remain at their workplace. The expected benefits are improved management of patients experiencing cardiac arrest through regular training and maintenance of the technical skills of paramedical and medical healthcare professionals in cardiopulmonary resuscitation (CPR). This is a retrospective cohort study evaluating the impact of a pre-/post-training intervention on the level of technical skills used by healthcare professionals in the management of cardiac arrest.

The Variation in Electrode Configuration for Termination of Out-of-Hospital Rhythms That Are Shockable in Cardiac Arrest Trial

The purpose of this study is to compare the effectiveness of two defibrillator pad placements, one where pads are placed on the front of the chest and back (anterior-posterior \[AP\]) and one where the pads are placed on the front and side of the chest (anterior-lateral \[AL\]), for the treatment of cardiac arrest. Both pad placement locations are recommended for use by the American Heart Association (AHA) and International Liaison Committee on Resuscitation (ILCOR) and are used in standard treatment. The investigators are hoping to find out if one pad position is more effective than the other in the treatment of cardiac arrest.

Effects of a Web-based Support Programme for Cardiac Arrest Survivors

The overall goal of this clinical trial is to learn if a web-based support programme can improve wellbeing in cardiac arrest survivors by helping them manage emotional, cognitive, and physical challenges. The study also explores how the programme is used and experienced in practice. The main questions it aims to answer are: * Can access to a web-based support programme improve overall wellbeing in cardiac arrest survivors? * Can it also enhance quality of life, cognitive function, life satisfaction, and sleep, while reducing anxiety, depression, post-traumatic stress, and fatigue? Researchers will compare cardiac arrest survivors who receive a web-based support programme in addition to standard care with those who receive standard care alone, to see if the programme improves wellbeing and other health outcomes. After the study, the control group will also gain access to the programme. Participants will: * Be asked to complete online questionnaires at three time points: at the start of the study, after 3 months, and after 6 months. * Be encouraged to use a web-based support programme for 3 months, with unlimited access, at their own pace and according to their individual needs (intervention group only).

Multiomics Profiling of CSF in Cardiac Arrest Survivors

The goal of this observational study is to identify further pathophysiologic mechanism of secondary brain injury following cardiac arrest by using serial multiomics profiling of serum and cerebrospinal fluid (CSF) samples. The main question it aims to answer is: A. The main question it aims to answer is: What are the dynamic molecular changes in serum and CSF that reflect the pathophysiological mechanisms of secondary brain injury after cardiac arrest? B. What are the differences in serum and CSF multiomic signatures between varying severities of cardiac arrest, and how are these differences associated with the underlying pathophysiological mechanisms of secondary brain injury? Serum and CSF samples that have already been prospectively collected from participants and stored in the BioBank will be used for this analysis.

Augmented Reality-Cardiopulmonary Resuscitation Support for Pediatric Resuscitation

This study evaluates whether an augmented reality cardiopulmonary resuscitation feedback system (AR-CPR) can support health care providers in delivering high-quality chest compressions during pediatric cardiac arrest. AR-CPR provides real-time visual feedback on chest compression rate, depth, and recoil through a head-mounted augmented reality display. In this randomized, multicenter, international, simulation-based non-inferiority study, health care providers perform chest compressions during an 18-minute simulated pediatric cardiac arrest. Participants are assigned to receive either real-time feedback from AR-CPR or coaching from a trained human CPR coach. The primary objective is to determine whether the percentage of chest compressions meeting guideline targets for both rate and depth with AR-CPR is non-inferior to that achieved with human CPR coaching.

Cor360: Clinician-Facing Broad-Spectrum Cardiac Phenotyping and Risk Assessment Using COR® Wearable ECG to Inform Outcomes-Oriented Care Pathways

Cor360 is an observational study evaluating whether extended wearable electrocardiogram (ECG) data can support broad-spectrum cardiac phenotyping and risk assessment beyond conventional single-purpose ambulatory rhythm monitoring. The study evaluates a clinician-facing, AI-enabled decision-support system that analyzes data from the Cor XT and Cor MDx wearable ECG devices and organizes patient-specific findings into an integrated Cor360 report for review by qualified clinicians. Rather than focusing only on detection of arrhythmias, Cor360 evaluates multiple dimensions of cardiovascular physiology and disease simultaneously. The active Cor360 indication panel may include more than 150 reportable findings or sub-findings organized across six clinically oriented pathways: Structural, Functional, Conductance, Hemodynamic, Neurohormonal/Autonomic, and Atrial Fibrillation/Ventricular Arrhythmia/Sudden Cardiac Death. Depending on the ECG data available for an individual participant, Cor360 may characterize findings and risk markers related to left ventricular hypertrophy and atrial enlargement; heart-failure phenotype and ejection-fraction-related abnormalities; conduction delay and heart block; repolarization and ischemia-related abnormalities; atrial fibrillation and atrial substrate; ventricular ectopy, nonsustained ventricular tachycardia and electrical-instability markers; syncope mechanisms; and selected ECG-derived hemodynamic and structural/functional surrogates. The platform may also evaluate autonomic regulation and heart-rate variability, cardiopulmonary coupling, sleep-disordered breathing and obstructive sleep apnea screening indicators, electrolyte-related ECG abnormalities, and other clinically relevant physiologic patterns. Cor360 is designed to move from isolated ECG findings toward multidimensional cardiac phenotyping and multi-pathway risk assessment. Individual findings may be combined into clinically meaningful phenotypes and risk profiles, such as atrial-fibrillation-prone substrate, heart-failure-related autonomic or repolarization profiles, ventricular electrical-instability patterns, ischemia-related risk signals, or sleep-disordered-breathing-related cardiovascular burden. Where repeated ECG studies are available, Cor360 may also assess changes in cardiac phenotype, physiologic state, and risk trajectory over time. Reports are individualized rather than identical across participants. Only indications supported by the participant's available data, signal quality, monitoring duration, and applicable analysis criteria are presented. Longer-duration recordings may support deeper assessment of autonomic function, sleep-related physiology, intermittent abnormalities, and longitudinal risk patterns. Cor360 also evaluates whether an extended wearable ECG record can support cross-domain clinical synthesis rather than requiring each physiologic signal to be interpreted in isolation. When appropriate, reports may link detected phenotypes and risk markers to guideline-informed care-pathway considerations while identifying uncertainty, data-quality limitations, and findings that are not reportable because monitoring-duration or signal criteria are not met. The primary objective of the study is to determine whether clinicians judge Cor360 reports to provide clinically actionable cardiac phenotyping or risk-assessment information. The study will also evaluate whether reviewing a Cor360 report changes, refines, or confirms a clinician's assessment or intended care pathway, and how Cor360 findings agree with available clinical reference information, standard-of-care testing, or independent expert review. The study includes adults 18 years of age or older with completed or planned Cor XT or Cor MDx wearable ECG monitoring. It includes retrospective and prospective single-study assessments, longitudinal repeated-study assessments, combined retrospective/prospective analyses, and selected limited-duration streaming or patient-activated event assessments. The protocol spans real-world acquisition settings, including home, clinic, ambulatory care, emergency department/triage, ambulance or transport, hospital-based, and hybrid clinic-to-home workflows. Where suitable reference information is available, Cor360 findings may be compared with 12-lead ECG interpretation, Holter or ambulatory ECG findings, echocardiography, other imaging, laboratory results, sleep testing, clinical diagnosis, or blinded expert-panel review. Cor360 is being evaluated as a clinician-facing decision aid and not as an autonomous diagnostic system. Its outputs are intended to augment clinical interpretation and support consideration of relevant care pathways, including rhythm management, heart-failure evaluation, ischemia assessment, conduction or pacing evaluation, and sleep-apnea work-up. The clinician remains responsible for diagnosis, treatment, testing, referral, and patient management.

Does Increasing the Compression Pause From 3 to 5 Seconds in Mechanical Compression Devices Increase Ventilation Success Rate and Return of Spontaneous Circulation?

To give chest compressions during cardiopulmonary resuscitation (CPR), mechanical chest compression devices can be used. During synchronous 30:2 CPR, the standard setting on these devices leave an automated 3-second chest compression pause after 30 compressions to facilitate caregivers in providing two ventilations. With this standard setting, research has shown that in less than half of ventilation pauses during CPR, those two ventilations are given. Increasing the ventilation pause duration to 5 seconds instead of 3 seconds is also an option following current guideline recommendations, and aligns with measured ventilation pause duration in manual CPR. Increasing pause duration to 5 seconds could result in an increased ventilation success rate. This multicenter randomized controlled trial will randomize LUCAS® mechanical compression devices to a standard setting of 3- or 5-second compression pauses. The main outcome will be the percentage of ventilation pauses in which two ventilations are successfully given. Secondary outcomes include the restoration of spontaneous circulation (ROSC), and the difference in (neurologically intact) survival. No study has been performed to evaluate this effect yet.

Effectiveness of a Communication Training Program in Improving the Handling of Calls for Suspected Cardiac Arrest at SAMU-Centre 15.

Each year, France's emergency response services-the SAMU (15) and the fire department (18)-handle 31 million and 19 million calls, respectively. The effectiveness of this system depends on the call centers' ability to obtain location information, prioritize responses, assess the severity of each call, and dispatch appropriate emergency resources. Cardiac arrest (CA) affects 40,000 people in France each year who call on this service. The survival rate decreases by 7 to 10% for every minute that elapses between cardiac arrest and the start of cardiopulmonary resuscitation (CPR). Early CPR performed by bystanders is associated with a survival rate 2-3 times higher than CPR initiated only after emergency responders arrive on the scene. CPR assisted by SAMU-Centre 15 dispatchers (T-CPR) is a way to provide CPR to patients before emergency responders arrive on the scene and is recommended as early as possible to improve survival. According to the American Heart Association (AHA) guidelines, the timing of the initiation of the chain of survival is considered high quality if T-CPR is initiated within 90 seconds. Studies show that recognizing a cardiac arrest (CA) over the phone is often difficult for several reasons, including communication challenges, the caller's stress, and the presence of abnormal breathing. Emergency medical dispatchers (EMDs) receive very little training on communication strategies, particularly those needed to optimally manage stressed and sometimes difficult callers. Interventions to improve communication have proven effective among healthcare professionals. These methods included face-to-face training, blended learning programs, simulation-based teamwork exercises, and communication techniques adapted from aviation. Standardized scripting systems have been shown to improve the speed of decision-making and the dispatch of emergency response teams. These scripts depend on the quality of the information provided by the caller and the caller's ability to communicate effectively with the EMD. The objective of this study will be to evaluate the effect of a communication training program for Centre-15 emergency medical dispatchers on calls for cardiac arrest.

Breakthrough Platform Trial for PCAS

The goal of this platform clinical trial is to evaluate whether specific post-cardiac arrest care strategies can improve neurological recovery and survival in adult patients who remain comatose after return of spontaneous circulation (ROSC) following cardiac arrest and require intensive care management. This multicenter cluster-randomized crossover platform trial (BPT-PCAS) evaluates post-cardiac arrest care strategies within a shared master protocol structure. Participating hospitals are randomized at the institutional level to predefined treatment strategies for fixed study periods and subsequently cross over to alternative strategies according to a predefined allocation schedule. The platform is designed to accommodate multiple independent intervention domains, each evaluating a different post-cardiac arrest care strategy under shared eligibility criteria, infrastructure, data management systems, and follow-up procedures. Participants may be enrolled in one or more active intervention domains according to platform availability and eligibility. Participants will receive the post-cardiac arrest care strategy assigned to their participating hospital during the study period while otherwise undergoing standard intensive care management according to local practice and study protocols. Participants will be followed for neurological outcomes including modified Rankin Scale (mRS), mortality, and safety outcomes at hospital discharge, 30 days, and 90 days after hospital admission.