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District joins world-leading cardiac arrest treatment trial

RPA and Concord among 15 hospitals participating in EVIDENCE trial.

Healthcare workers pushing a patient out of an ambulance bay
SydneyConnect Image: A world-leading randomised control trial with NSW Ambulance

More than 20,000 Australians suffer a cardiac arrest outside of hospital every year – but only one in 10 survive.

Now, RPA and Concord hospitals are part of a world-leading randomised control trial with NSW Ambulance to find the very best way to treat cardiac arrest patients and ensure their survival.

The EVIDENCE trial, which started in July and continues for two years, involves more than 1300 paramedics and 15 hospitals across Sydney and Wollongong.

It tests various methods of mechanical CPR such as the Lucas device which automatically delivers chest compressions and ECMO (extracorporeal membrane oxygenation), a heart/lung bypass machine which gives the patient's heart a chance to rest while clinicians diagnose and treat the cardiac arrest.

About 400 Lucas devices are currently in ambulances across the state.

"The trial is currently the largest of its kind in the world being undertaken in terms of geography, paramedics and hospital numbers involved," Dr Mark Dennis, an RPA cardiologist and chief trial investigator, said.

"Early recognition of cardiac arrests, effective bystander CPR which ensures good blood flow to the brain and heart, defibrillation and more advanced medical interventions are critical in improving survival rates.

"Recent overseas studies, in smaller cities and involving only one hospital, have shown that bundles of out-of-hospital cardiac arrest care, including early recognition, early transfer, mechanical CPR during extrication and transport and coronary angiography and ECMO are beneficial in selected patients," Dr Dennis said.

RPA is a leading site in NSW for ECMO, sharing statewide ECMO retrieval team duties with St Vincent's Hospital.

This week, RPA and NSW Ambulance clinicians ran a simulation exercise in Camperdown where a "patient" (a mannequin) suffering a cardiac arrest was placed on a Lucas device on scene by intensive care paramedics and taken to RPA's Emergency Department where ICU and ED staff put them on ECMO, within minutes of arrival.

"Time is a critical aspect of cardiac arrest management. Carefully selected patients must be placed on ECMO in under 60 minutes from the time of the arrest for a meaningful outcome," Dr Dennis said.

NSW Health Minister Brad Hazzard, who attended the simulation, said the EVIDENCE trial which should shape cardiac arrest care around the world, would "make sure that families will have more of their loved ones come home."

Other participating hospitals include Northern Beaches, Royal North Shore, Westmead, Nepean, Liverpool, Sutherland, St George, St Vincent's, Prince of Wales, Wollongong, Blacktown, Campbelltown and Bankstown.