Preventing rearrest after out-of-hospital cardiac arrest with a paramedic post-ROSC care protocol

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

The RE-ARREST project develops and implements an evidence-based prehospital post-resuscitation care protocol tailored for paramedic-led Emergency Medical Services. The intervention emphasizes structured monitoring, tailored oxygenation and ventilation targets, vasopressor guidance, and clear procedures for transport and handoff to hospital teams. The protocol will be applied to adults with out-of-hospital cardiac arrest who achieve return of spontaneous circulation before hospital arrival and are transported by Siriraj EMS to Siriraj Hospital. Primary outcomes include rearrest rates prior to hospital arrival, survival to hospital discharge, and feasibility of protocol delivery in a resource-constrained prehospital setting.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Adults aged 18 years or older.
* Patients with out-of-hospital cardiac arrest (OHCA) who received resuscitative care from the Siriraj Emergency Medical Services Center (SiEMS).

Patients who achieved return of spontaneous circulation (ROSC) prior to hospital arrival.

\- Patients subsequently transported to the Emergency Department of Siriraj Hospital for further treatment.

Exclusion Criteria:

* Suspected traumatic cardiac arrest.
* ROSC patients whose legally authorized representative declined vasopressor administration, despite clinical indication according to the prehospital post-resuscitation care protocol.
* ROSC patients who had not undergone endotracheal intubation, and whose legally authorized representative declined endotracheal intubation, despite protocol-based indication.
* ROSC patients without rearrest whose legally authorized representative declined further blood investigations or additional procedures after arrival at the Emergency Department.
* Patients whose legally authorized representative declined participation in the study.
* Patients without an available legally authorized representative to provide consent for study participation.

Where it's running

• Faculty of Medicine Siriraj Hospital, Mahidol University
  Bangkok Noi, Bangkok, Thailand Recruiting

Study contacts

• Principal investigator: Sattha Riyapan, MD MPH — Mahidol University
• Study coordinator: Sattha Riyapan, MD MPH
• Email: sattha.riy@mahidol.ac.th
• Phone: +66994489090

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.