Major research initiatives have been in the field of Prehospital Care.  These completed and ongoing projects designed have led to a research program to improve the care and survival for out-of-hospital cardiac arrest and trauma patients. 

1) Cardiac Arrest Epidemiology in Canada
Commissioned by the Canadian Cardiovascular Outcomes Research Team, Dr. Vaillancourt led 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.

2) 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.  Members of this network include a number of internationally recognized scientific experts from 11 participating centers across North America and include Dr. Vaillancourt who plays a major role in the network. He is the primary author on ROC proposals to examine the role of chest compression fraction in non-ventricular fibrillation patients, as well as being a co-author on additional ROC proposals. Many of these have been published in very high impact journals such as NEJM, JAMA, Circulation, and CMAJ.

3) Prehospital Validation of the Canadian C-Spine Rule by Paramedics
The Canadian C-spine Rule is a clinical decision tool that helps healthcare professionals methodically review variables significant to a treatment decision for cervical spine injury.  In the pre-hospital treatment regimen, suspected cervical spine injury is always treated with spinal immobilization, however 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 with emergency physicians which involved two large multi-center studies of 17,207 alert and stable emergency department trauma patients, in the identification and safe removal of cervical spine immobilization without the need for diagnostic imaging. Dr. Vaillancourt 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. A follow-up study was implemented with CIHR-funding allowing for selective immobilization of alert and stable trauma victims in Ottawa.

4) Dispatch-assisted CPR Instructions
Dr. Vaillancourt has published an 18-month review of all 9-1-1 calls involving cardiac arrest victims in Ottawa in Academic Emergency Medicine. It was 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. More recently, he 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, a reported moderate but significant increase in overall survival. In addition, he has 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.  Currently, a dispatcher training program has been implemented at the Ottawa Paramedic Service and is being evaluated.


CPR Training Promotional video with the Ottawa Paramedic Service

5) Review of Scientific Evidence on the Diagnosis of Cardiac Arrest by Emergency Medical Dispatchers for the International Liaison Committee on Resuscitation
Dr. Vaillancourt was 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 discussed at several international webinars, and were presented during the 2010 International Consensus meeting on CPR and Emergency Cardiac Care Science. The recommendations were incorporated into 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.  Dr. Vaillancourt is also involved in the review of the evidence on dispatch-assisted CPR which will be included in the 2015 Resuscitation Guidelines.