Initiation of Cooling by Emergency medical services to Promote the Adoption of in-hospital therapeutic hypothermia in Cardiac arrest Survivors (ICEPACS)
During a cardiac arrest many patients have severe brain damage caused by lack of blood flow. Research has shown us thus far that we can often prevent this brain damage by cooling a patient’s body temperature once they arrive in the hospital. This treatment is also known as “Therapeutic Hypothermia”. The ICEPACS trial is being implemented in EMS across Ontario in hopes that starting Therapeutic Hypothermia in patients while in the care of EMS will improve the patient’s chances of survival and with little to no brain damage. ClinicalTrials.gov: NCT01528475
Update – February 2016: ICEPACS enrollment is complete!
| Emergency Medical Services | Halton | Peel Region | Toronto | York | Total |
| Total Enrollment | 91 | 253 | 177 | 65 | 586 |
A special thank you goes out to the paramedics for your dedication and support! You are pioneers in advancing the standard of patient care in this province.
Gender
Over the last two decades many studies have suggested that women have unfavourable outcomes in cardiac arrest, with significantly lower unadjusted survival rates than men. Building on the SPARC network of 37 participating hospitals in Southern Ontario, we conducted a prospective cohort study of consecutive adult out-hospital cardiac arrest (OHCA) with a return of spontaneous circulation (ROSC). Results here. Manuscript in progress.
We are also conducting a qualitative study to identify potential sociological sources of gender differences by interviewing patients, families and physicians involved in the care of post arrest patients. We will use this information to develop a knowledge transfer strategy in concert with our network of experts and local champions to address this inequity in post arrest care and potentially contribute to improved survival for women in the future.
This work will contribute to capacity building in resuscitation research by supporting the work of University of Toronto’s Dr. Valeria Rac and St. Michael’s Dr. Katie Dainty
Preventing Premature Termination of Resuscitation in Survivors of Cardiac Arrest (PremaTOR)
Our previous research suggests that many patients have life support withdrawn much earlier than the suggested minimum of 72 hours after an out of hospital cardiac arrest has occurred, before accurate predictions about neurological prognosis can be made. This stepped-wedge study design focuses on using innovative knowledge translation strategies to improve prognosis for survivors of cardiac arrest and prevent premature termination of life sustaining therapies. ClinicalTrials.gov: NCT01472458
PremaTOR launched in November 2011 and was completed in June 2014.
The impact of a Post Arrest Consult Team on process and clinical outcomes in patients resuscitated from out-hospital cardiac arrest (PACT)
The pilot project for SPARC measured the clinical and knowledge translation process changes to determine effectiveness of post arrest consult team (PACT) implementation. Patients in the intervention group were less likely to have premature withdrawal of life-sustaining therapy (WLST<72 hours). Further investigation of the PACT model is underway. Results here.
