Background and purpose of the study
Extracorporeal cardiopulmonary resuscitation (eCPR) is a promising second line therapy for selected cases of cardiac arrest (CA). A time period of 60 minutes from onset of CA until start of eCPR, appears to be a predictor for surviving. [1] Because of short transport distances in urban areas probably the most time-consuming and also objectively modifiable part is the Scene Time Interval (STI).
The purpose of this study was to find out, if a time-optimized management with focus on early transport is able to reduce the STI, without affecting the quality of CPR.

Materials and methods
We conducted a prospective manikin simulation study. 4 Ambulance teams underwent a total of 6 CA Scenarios. After 2 control-scenarios the teams were instructed on the time-optimized management existing of: Spineboard® is initially brought to a known CA patient, patient is immediately placed on the Spineboard®, use of mechanical CPR and transport to ambulance car as early as possible. Afterwards 2 scenarios with application of the new management were played. One week later another control- and interventional- scenario were held.

Results
There was a significant reduction of the STI (22:06 +/- 04:35 vs. 14:28 +/- 01:19, p=.001). Further there was a significantly earlier use of mechanical CPR (2:56 +/- 1:40 vs. 1:10 +/- 00:27, p=.004) and earlier start of transport to the ambulance car (12:44 +/- 3:30 vs. 6:10 +/- 1:27, p=.001). Parameters of quality of CPR did not differ between intervention- and controlscenarios.

Conclusions
By using a time-optimized management with focus on early transport it was possible to significantly reduce the STI enabling selected patient being treated with ECPR at a time point with higher odds for success.

2 - The Transport In Medical Emergency Simulation Study (TIME-Sim)