Project Leader:  Dr. Ellen Lopez | Montana State University

Survey Consent Forms

Download Consent Form for Directors

Download Consent Form for Agency Personnel

Abstract

Significant advances in out-of-hospital survival from cardiac arrest (CA) has improved over the past 15 years due to factors grouped into patient factors, event factors, system factors, and therapy factors. It is expected that many of these improvements have not been realized in rural Alaska; traditional home to Alaska Native peoples. Neither incidence nor survival after CA is known for rural Alaska. Nor is it known what improvements in CA care is available and what barriers prevent widespread implementation of evidence based care. Targeted temperature management (TTM) is one example of an evidence-based intervention that contributes to increased survival and neurological outcomes after cardiac arrest. A long-term goal of research in the PI’s laboratory is to simplify TTM to make it more accessible to rural emergency medical services, especially those impacting rural Alaska. Preclinical studies in the Drew laboratory show safety and efficacy of A1 adenosine receptor agonists as thermolytic adjuncts to facilitate TTM. Thermolytic drugs simplify TTM by inhibiting shivering and non-shivering thermogenesis. Study of CA in rural Alaska is expected to reduce health disparities by providing estimates of incidence of CA and promoting participation in the CARES registry. This study will also inform emergency medical service (EMS) directors about which factors impact EMS care and it will shape preclinical development of thermolytic drugs.

Research Aims 

  1. Estimate the incidence of CA in rural Alaska, including the identification of barriers and system-level factors relevant to the documentation of prehospital care for this population.
  2. Identify and understand which, how and why CA survival rate factors impact EMS care across rural Alaska (from the perspective of EMS directors).
  3. Characterize the perspectives of Alaska-based EMS directors regarding how TTM might be optimized for prehospital care of CA patients across rural Alaska. Once completed we will have an estimate of the incidence of CA and measurement barriers in rural Alaska; a qualitative assessment of which CA survival factors impact pre-hospital care of CA patients in rural Alaska; and feedback from end-users to shape technology in TTM.

Relevance

Disparities exist between urban and rural hospitals in survival after cardiac arrest, however neither incidence of cardiac arrest nor factors influencing survival are known for rural Alaska Native villages. This information as well as end-user feedback on new technology for targeted temperature management is expected to decrease health disparities in rural Alaska.