Christian Vaillancourt MD, MSc, FRCPC, CSPQ
cvaillancourt@ohri.ca
Senior Scientist, Clinical Epidemiology, Ottawa Hospital Research Institute
Associate Professor, Department of Emergency MedicineResearch Chair in Emergency Cardiac Resuscitation, University of Ottawa
Associate Medical Director of Research, Regional Paramedic Program for Eastern Ontario
MOST SIGNIFICANT CONTRIBUTIONS
My major research initiatives have been in the field of Prehospital Care:
Over the past seven years I have designed and led a number of projects as part of a research program to improve the care and survival for out-of-hospital cardiac arrest and trauma victims.
a) Cardiac Arrest Epidemiology in Canada
I was commissioned by the Canadian Cardiovascular Outcomes Research Team to lead a report on cardiac arrest care and emergency medical services in Canada. This project, supported by the Heart and Stroke Foundation of Canada and the Institute for Clinical Evaluative Sciences, resulted in the first national statistics on cardiac arrest ever published. It highlighted regional variations in cardiac arrest care and survival rates, as well as the need for a cardiac arrest surveillance program in Canada. It involved leadership in recruiting the collaboration of other national experts in the field of cardiac arrest in Canada. This series of reports later received the Robert E. Beamish Award, for original research judged to have the greatest potential impact on cardiovascular medicine published in the Canadian Journal of Cardiology, and a CIHR National Knowledge Translation Award.
b) Participation as Co-Investigator in the Resuscitation Outcomes Consortium (ROC)
The ROC is the largest clinical trial network in the world focusing on research in the area of pre-hospital cardiopulmonary arrest and severe traumatic injury. I am playing a major role among a number of internationally recognized scientific experts from 11 participating centers across North America. I am the primary author on 2 ROC proposals to examine the role of chest compression fraction in non-ventricular fibrillation patients, as well as being a co-author on 9 additional ROC proposals (3 of which are already published in JAMA, Circulation, and Resuscitation; 3 other are being revised for NEJM, CMAJ, and Resuscitation).
c) Dispatch-assisted CPR Instructions
I have published an 18-months review of all 9-1-1 calls involving cardiac arrest victims in Ottawa in Academic Emergency Medicine. We determined that agonal breathing played a major role in the ability of dispatchers to recognize cardiac arrest over the phone, and that ventilation instructions were difficult to follow and often resulted in the inability of callers to initiate chest compressions before EMS arrival. Results from this trial were used to modify CPR instructions currently being provided by dispatchers to 9-1-1 callers in Ontario. I have most recently completed a CIHR-funded multi-center observational trial on dispatch-assisted CPR instructions in Ontario. In this before-after study, dispatch-assisted CPR resulted in an important increase in bystander CPR rate and, for the first time in the world's literature, in a moderate but significant increase in overall survival. In addition, I have recently completed a HSFO-funded national behavioral survey of 9-1-1 emergency medical dispatchers exploring which theoretical construct can better explain the impact of agonal breathing on their ability to recognize cardiac arrest.
d) Review of Scientific Evidence on the Diagnosis of Cardiac Arrest by Emergency Medical Dispatchers for the International Liaison Committee on Resuscitation
I have been assigned to systematically review the science pertaining to the diagnosis of cardiac arrest by emergency medical dispatchers for the International Liaison Committee on Resuscitation. These findings were discusses at the occasion of several international webinars, and were presented during the 2010 International Consensus meeting on CPR and Emergency Cardiac Care Science. Our recommendations led to the revision of the 2010 Resuscitation Guidelines pertaining to dispatch-assisted CPR instructions. This international collaborative effort led to a new research partnership involving scientists from Canada, the U.S., Sweden, Scotland, and Belgium in the planning of an international research consortium on dispatch-assisted CPR instructions.
e) The Prehospital Validation of the Canadian C-Spine Rule by Paramedics
Less than 1% of all alert and stable minor trauma patients have a cervical spine injury. The Canadian C-Spine Rule was previously derived and validated in two large multi-center studies involving 17,207 alert and stable emergency department trauma patients, and allows for identification and safe removal of cervical spine immobilization without the need for diagnostic imaging. I have successfully validated the use of the C-Spine rule in a Canadian multi-center trial involving paramedics. The resulting manuscript, published in Annals of Emergency Medicine, was voted top 10 for 2009 by the National Association of Emergency Medical Service Physicians. We have recently implemented a CIHR-funded study allowing for selective immobilization of alert and stable trauma victims in Ottawa.
Most Recent Publications (provided by The Ottawa Hospital Library database)
Vaillancourt C;Midzic I;Taljaard M;Chisamore B;, (2011 Jan), Performer fatigue and CPR quality comparing 30:2 to 15:2 compression to ventilation ratios in older bystanders: A randomized crossover trial, Resuscitation, Vol.82, Issue 1, 51-56 -> view abstract
Vaillancourt C;Charette M;Kasaboski A;Maloney J;Wells GA;Stiell IG;, (2011 Feb 1), Evaluation of the safety of C-spine clearance by paramedics: design and methodology, BMC Emerg Med, Vol.11, Issue 1, 1 -> view abstract
Calder LA;Forster A;Nelson M;Leclair J;Perry J;Vaillancourt C;Hebert G;Cwinn A;Wells G;Stiell I;, (2010 Sep), Adverse events among patients registered in high-acuity areas of the emergency department: a prospective cohort study, CJEM , Vol.12, Issue 3, 421-430 -> view abstract
Bulger EM;May S;Brasel KJ;Schreiber M;Kerby JD;Tisherman SA;Newgard C;Slutsky A;Coimbra R;Emerson S;Minei JP;Bardarson B;Kudenchuk P;Baker A;Christenson J;Idris A;Davis D;Fabian TC;Aufderheide TP;Callaway C;Williams C;Banek J;Vaillancourt C;van HR;Sopko G, (2010 Oct 6), Out-of-hospital hypertonic resuscitation following severe traumatic brain injury: a randomized controlled trial, JAMA , Vol.304, Issue 13, 1455-1464 -> view abstract
Stiell IG;Dickinson G;Butterfield NN;Clement CM;Perry JJ;Vaillancourt C;Calder LA;, (2010 Nov), Vernakalant Hydrochloride: A NovelAtrial-selective Agent for the Cardioversionof Recent-onset Atrial Fibrillation in the Emergency Department, Acad Emerg Med, Vol.17, Issue 11, 1175-1182 -> view abstract
Stiell IG;Clement CM;Perry JJ;Vaillancourt C;Symington C;Dickinson G;Birnie D;Green MS;, (2010 May), Association of the Ottawa Aggressive Protocol with rapid discharge of emergency department patients with recent-onset atrial fibrillation or flutter, CJEM, Vol.12, Issue 3, 181-191 -> view abstract
Vaillancourt C;Charette M;Stiell IG;Phillips KR;Wells GA;, (2010 Mar), Out-of-hospital cardiac arrest surveillance in Canada: a survey of national resources, Canadian Journal of Emergency Medicine, Vol.12, Issue 2, 119-127 -> view abstract
