Study to help patients breathe easier

East Carolina University will be working in conjunction with the University of Pittsburgh on a research study called PACT: Prehospital Airway Control Trial. PACT is an $8.8 million, four-year, Department of Defense-funded clinical trial aimed at improving survival among people who have difficulty breathing after a trauma.

PACT will begin during 2020 and will test different strategies for helping patients breathe at the scene of a trauma to see if one method works better than another at increasing survival. PACT is an “exception from informed consent” trial, which means that because the trial requires performing a potentially life-saving procedure on people who are too injured to give permission, patients who need help breathing will be enrolled. Once patients or families are able to consent, they will be asked to grant permission for their medical data already collected during prehospital treatment to be included in the study in order to help future patients.

The Prehospital Airway Control Trial will focus on eastern North Carolina counties serviced by Vidant EastCare; the local EMS agencies of Lenoir, Wilson and Pitt counties; and Greenville Fire and Rescue in the City of Greenville. (Photo by Cliff Hollis)

“I am excited that East Carolina University has been selected to participate in the PACT study,” said Dr. Joanna Adams, site principal investigator, clinical assistant professor of emergency medicine at ECU’s Brody School of Medicine and associate medical director for Vidant EastCare. “We serve a rural population in eastern North Carolina that represents an underrepresented but very important population in trauma care. This study has the potential to improve the management of trauma patients in our area and allows eastern North Carolina the opportunity to change trauma care on a national level.”

One in five preventable deaths in trauma cases occur because the patient is having difficulty breathing without assistance. First responders and medical professionals typically use one of two main airway management methods when preparing patients to be transported to the hospital. One method uses an endotracheal tube, which goes directly into the windpipe. Another method uses a supraglottic airway (SGA), which sits above the windpipe. Either device is then connected to a ventilation device—either a machine or a bag that can be pumped by hand—to deliver oxygen to the lungs.

Although both methods are currently used, ECU seeks to understand which is better. To test this, the study’s investigators will ask local EMS agencies to use their standard method of helping people breathe and then to compare that with an SGA first approach.

For ECU’s research purposes, the study will focus on eastern North Carolina counties serviced by Vidant EastCare; the local EMS agencies of Lenoir, Wilson and Pitt counties; and Greenville Fire and Rescue in the City of Greenville, N.C.

The investigators will then compare the results of the methods used by the two groups. Regardless of the study, the injured person will still need help breathing and will receive breathing assistance, most likely by one of the two methods described above.

For more information, please visit the study’s website at www.litesnetwork.org/pact. For

more information or inquiries about PACT, please e-mail PACTstudy@edc.pitt.edu.

-by Spaine Stephens, University Communications