Exploring and Improving Resuscitation Decisions in Out of Hospital Cardiac Arrest (PROTECTeD)

Funding body NIHR Health Services and Delivery Research Programme
Total funding  £617,200
  • Prof Gavin Perkins, University of Warwick
  • Dr Mike Smyth, University of Warwick
  • Prof Frances Griffiths, University of Warwick
  • Prof Anne-Marie Slowther, University of Warwick
  • Prof Ranjit Lall, University of Warwick
  • Prof A. Niroshan Siriwardena, University of Lincoln
  • Prof Rachael Fothergill, London Ambulance Service
  • Dr Terry Brown, University of Warwick
  • Mr John Long, Patient and public contributor
  • Prof Aileen Clarke, University of Warwick
  • Prof Stavros Petrou, University of Warwick
  • University of Warwick
  • University of Lincoln
  • London Ambulance Service NHS Trust
  • West Midlands Ambulance Service NHS Trust
Overarching aim To help NHS paramedics make better decisions about when to continue and when to stop resuscitation.
Objectives Research objectives are to:

  • Review research undertaken by others and see how it can be used in the NHS
  • Find out how ambulance services currently make decisions to stop or carry on with treatment
  • See what the effects different guidelines may have on how ambulance staff treat patients and any knock-on effects for hospitals
  • Talk to ambulance and hospital staff, patients and relatives. This will help us find out what they think and what is important to them.
  • Combine the information above to write new guidelines in partnership with ambulance and hospital staff, patients and members of the public.
Methods Multiple and mixed methods including:

  • Systematic review describing the content and performance characteristics of existing termination of resuscitation rules in adults who are treated for out of hospital cardiac arrest.
  • Survey identifying areas of consistency, variation and clinical risk associated with termination of resuscitation practices across UK ambulance services.
  • Database analysis examining current NHS ambulance termination of resuscitation practice and model effects of alternative rules on patient flow and outcomes.
  • Interviews exploring perspectives of patients, relatives, paramedics and emergency medicine staff and consider the ethical aspects of termination of resuscitation rules.
  • Synthesis of information obtained above to develop a consensus guideline that optimises patient outcomes and are sensitive to needs of relatives and demands on NHS services.
Outcomes An evidence informed, ethically grounded termination of resuscitation guideline, which is acceptable to NHS staff, patients and their relatives.
Outputs Peer reviewed publications.

Conference presentations.

Impact The guideline is anticipated to change clinical practice through adoption by NHS Ambulance Services, through the Joint Royal College Ambulance Liaison Committee and Resuscitation Council (UK) leading to better decisions for patients, their relatives and the NHS.