Clinical Research
To assist in the improvement of advanced emergency medical care, the San Francisco Fire Department frequently participates in bona fide research studies and programs. Activities in this area include sponsored clinical investigations, pilot projects, or investigations of new treatment modalities. Below is a list of past, current and proposed SFFD research activities:
Cardiac Arrest Registry to Enhance Survival (CARES)
SPONSORED BY: Centers for Disease Control and Prevention (CDC), American Heart Association (AHA), Emory University Department of Emergency Medicine
DESCRIPTION: See CARES
RESEARCH PERIOD: March 2009 to present (ON-GOING)
Sudden Cardiac Arrest Genetic Analysis
SPONSORED BY: University of California San Francisco, Department of Cardiac Electrophysiology
DESCRIPTION: Blood samples collected from cardiac arrest patients are used to measure the single nucleotide polymorphisms in the beta receptors and correlate them with cardiac arrest propensity as compared to a control group. We began collecting samples in January 2009 and are making plans to add blood collection from suspected STEMI patients in 2010. We are planning on continuing the collection of the pilot data for a future research grant application.
RESEARCH PERIOD: January 2009 to present
Rapid Anticonvulsant Medication Prior to Arrival Trial (RAMPART)
SPONSORED BY: University of California San Francisco, National Institute of Health (NIH), Neurological Emergencies Treatment Trials Network (NETT)
DESCRIPTION: See RAMPART
RESEARCH PERIOD: July 2009 to January 2011
PUBLICATIONS: "Intramuscular versus Intravenous Therapy for Prehospital Status Epilepticus" (New England Journal of Medicine: February 16, 2011) http://www.nejm.org/doi/full/10.1056/NEJMoa1107494
ARTICLES: "Improved Emergency Treatment for Prolonged Seizures" (UCSF News Center: February 15, 2012) http://www.ucsf.edu/news/2012/02/11535/improved-emergency-treatment-prolonged-seizures ; "Seizure patients could get new help, study says" (San Francisco Chronicle: February 16, 2012) http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2012/02/16/BAAU1N84CU.DTL
Capnography & Prognosis Trends in Ventricular Arrest (CAPTIVA)
SPONSORED BY: ZOLL Medical Corporation
DESCRIPTION: Measurement of end-tidal carbon dioxide and characteristics of capnography and ventricular fibrillation waveforms to predict probability of survival from out-of-hospital sudden cardiac arrest; Study included analysis of capnography, defibrillator, and documented medical care data.
RESEARCH PERIOD: November 2003 to October 2006
AutoPulseTM Resuscitation Device Evaluation
SPONSORED BY: Revivant Corporation, Inc.
DESCRIPTION: Comparison of resuscitation outcomes following pre-hospital atraumatic sudden cardiac arrests using an automated chest compression device to perform external chest compressions as an adjunct for manual CPR; Evaluation of device performance after deployment and use.
RESEARCH PERIOD: July 2002 to June 2004
PUBLICATIONS: "The impact of a new CPR assist device on rate of return of spontaneous circulation in out-of-hospital cardiac arrest." (http://www.ncbi.nlm.nih.gov/pubmed/16036830 )
Pre-Hospital Treatment of Status Epilepticus (PHTSE)
SPONSORED BY: University of California San Francisco, National Institute of Health (NIH)
CONDUCTED BY: SFDPH Paramedic Division (now SFFD)
DESCRIPTION: Comparison of lorazepam, diazepam and placebo for the treatment of out-of-hospital status epilepticus; First NIH-funded prehospital trial; Study helped determine the value of diazepam vs. lorazepam in treatment of seizures; Also demonstrated that a prospective randomized trial could be conducted in the field, and set the benchmark for future waiver-of-consent research.
RESEARCH PERIOD: January 1994 to January 1999
PUBLICATIONS: "A comparison of lorazepam, diazepam and placebo for the treatment of out-of-hospital status epilepticus." (http://content.nejm.org/cgi/content/short/345/9/631)