Testing if feedback improves ambulance clinicians’ ventilations during CPR
| ISRCTN | ISRCTN61437539 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN61437539 |
| Central Portfolio Management System (CPMS) | 64807 |
| National Institute for Health and Care Research (NIHR) | 208154 |
| Sponsor | North East Ambulance Service NHS Foundation Trust |
| Funder | National Institute for Health and Care Research |
- Submission date
- 23/07/2026
- Registration date
- 27/07/2026
- Last edited
- 27/07/2026
- Recruitment status
- Not yet recruiting
- Overall study status
- Ongoing
- Condition category
- Circulatory System
Plain English summary of protocol
Background and study aims
A cardiac arrest occurs when the heart suddenly stops beating. NHS ambulance services attend approximately 30,000 cardiac arrests each year to provide cardiopulmonary resuscitation (CPR). CPR involves pushing up and down on the patient’s chest, chest compressions, and breathing for the patient, ventilations. Some patients respond to CPR and their heart starts beating again.
In the past it has been difficult to measure ventilations during CPR so less research has been done on ambulance clinician ventilations than on chest compressions. However, new technology enables ambulance clinicians to receive real-time visual feedback on their ventilations. We think that the feedback will help ambulance clinicians deliver better ventilations which may improve the chances of someone surviving a cardiac arrest.
The aim of this study is to complete a small trial of ventilation feedback during CPR by ambulance clinicians to decide if a larger trial is feasible and how best can it be conducted.
Who can participate?
Adults aged 18 years or older, who are in cardiac arrest and being attended by a North East Ambulance Service NHS Foundation Trust technician.
What does the study involve?
This study will involve ambulance clinicians in North East Ambulance Service (NEAS). The defibrillators used in NEAS will be set to show visual feedback on the defibrillator screen. In some cases, the ambulance clinician will receive feedback and in some cases they won’t. This will be decided by chance. This is known as a randomised controlled trial and is the best way of finding out which treatment is most effective. All patients will continue to receive all other normal treatments during CPR. We will follow up all patients involved in the study to see if they survive and how well they recover.
Results from the study will be shared with clinicians involved in resuscitation, academics and interested members of the public. This study will help us decide if a bigger study of ventilation feedback is needed and how to best deliver the bigger study.
What are the possible benefits and risks of participating?
The potential benefit is that we will learn more about how ambulance clinicians breathe for people in cardiac arrest which will inform more research in this area. There are no additional risks to patients as all patients are in cardiac arrest.
Where is the study run from?
North East Ambulance Service NHS Foundation Trust (UK)
When is the study starting and how long is it expected to run for?
Who is funding the study?
National Institute for Health and Care Research (NIHR) (UK).
Who is the main contact?
graham.mcclelland@northumbria.ac.uk
Contact information
Principal investigator, Scientific, Public
Northumbria University, Room H007, Coach Lane Campus East, Benton
Newcastle Upon Tyne
NE7 7XA
United Kingdom
 ORCID ID |
0000-0002-4502-5821 |
|---|---|
| graham.mcclelland@northumbria.ac.uk |
Public, Scientific, Principal investigator
University of Hertfordshire
Hatfield
AL10 9AB
United Kingdom
| ORCID ID |
0000-0003-0796-5465 |
|---|---|
| j.williams@herts.ac.uk |
Study information
| Primary study design | Interventional |
|---|---|
| Allocation | Randomized controlled trial |
| Masking | Open (masking not used) |
| Control | Uncontrolled |
| Assignment | Single |
| Purpose | Treatment |
| Scientific title | Ambulance clinician use of real-time ventilation feedback during cardiac arrest resuscitation to improve ventilation performance and patient outcomes: a randomised feasibility study |
| Study acronym | VANZ3 |
| Study objectives | The aim and primary objective of this study is to assess the feasibility of conducting a randomised controlled trial (RCT) to explore the impact of real-time visual feedback on ventilation rate and volume delivered by ambulance clinicians to patients in OHCA. |
| Ethics approval(s) |
Approved 22/04/2026, tbc (2 Redman Place, Stratford, London, E20 1JQ, United Kingdom; no telephone number provided; -), ref: 26/NE/0068 |
| Health condition(s) or problem(s) studied | Ambulance clinician use of real-time ventilation feedback during cardiac arrest resuscitation |
| Intervention | Research participants will be adult patients in cardiac arrest (no heartbeat, not breathing) who are resuscitated by ambulance clinicians in the North division of North East Ambulance Service. This is effectively the area between the River Tyne and the Scottish border. When patients are being resuscitated, they will receive cardiopulmonary resuscitation (CPR), which involves chest compressions and breathing for the patient (ventilation). Ambulance clinicians use a device called a bag-valve-mask to breathe for patients. This device allows them to force air into a patient's lungs via a facemask or tube inserted into the mouth. All ventilations should be delivered at around 10 per minute and around 500 mL (half a litre) of air. The study intervention is a device added to the equipment used to breathe for the patient, which will allow the defibrillator used by ambulance clinicians to help guide their ventilations. The defibrillator has a screen that shows clinical information such as heart rate and rhythm. The study intervention allows information on the rate and volume of ventilations to be displayed on the defibrillator screen. In order to test what impact this feedback has on ventilation quality, and ultimately patient outcomes, the defibrillators will be randomised so that half show feedback and half do not. This allows us to study the difference that the feedback makes. All defibrillators will record data on the quality of the ventilations delivered. All patients will receive the normal standard of care. The only difference is that some ambulance clinicians will have guidance on the defibrillator screen to help them ventilate at the right rate and volume. Unfortunately, most people do not survive a cardiac arrest. Currently, around one in ten people in England survive a cardiac arrest. Due to this low survival rate, the majority of patients enrolled in this study will not survive. We are seeking permission to include data from all patients who die without approaching anyone for consent, to minimise the amount of additional distress caused to families, relatives or loved ones during what will be a very traumatic time. For patients who do survive, they will be taken to hospital where their treatment will continue as part of normal care. We will talk to people in the hospital and monitor when would be a good time to approach the patient and/or their family or representative. We will seek consent at this point to include their data in the study. Our final point of contact with patients will be around 30 days after their cardiac arrest, when we will assess how many people survived and how they are doing at that point. As this is a feasibility study testing whether a larger study would be workable, we are looking to collect data from 80 patients over 8 months, which is an appropriate number of patients for a feasibility study. We will collect data on how often the ventilation feedback is used, the quality of the ventilations, what care is delivered to patients, and how many people survive. |
| Intervention type | Other |
| Primary outcome measure(s) |
|
| Key secondary outcome measure(s) |
|
| Completion date | 31/07/2027 |
Eligibility
| Participant type(s) | |
|---|---|
| Age group | Mixed |
| Lower age limit | 18 Years |
| Upper age limit | 120 Years |
| Sex | All |
| Target sample size at registration | 180 |
| Key inclusion criteria | 1. Adults (known or thought to be 18 years old or above) 2. In cardiac arrest 3. CPR performed by NEAS clinician 4. In the catchment area of the participating hospitals |
| Key exclusion criteria | 1. Paediatric patients (known or thought to be under 18 years old) 2. Non cardiac arrest (e.g., respiratory arrests) 3. Do not resuscitate order or equivalent 4. Ventilation needing to be performed at a rate and/or volume different to normal adult rate and/or volume |
| Date of first enrolment | 01/09/2026 |
| Date of final enrolment | 31/03/2027 |
Locations
Countries of recruitment
- United Kingdom
- England
Study participating centre
The Waterfront
Goldcrest Way
Newcastle upon Tyne
NE15 8NY
England
Results and Publications
| Individual participant data (IPD) Intention to share | Yes |
|---|---|
| IPD sharing plan | The datasets generated during and/or analysed during the current study are/will be available upon request from the study leads (Graham McClelland and Julia Williams, graham.mcclelland@northumbria.ac.uk. After the study is completed anonymised data may be made available for other researchers upon reasonable request and with appropriate ethical and governance approvals |
Editorial Notes
23/07/2026: Trial's existence confirmed by the National Institute for Health and Care Research (NIHR) (UK).
