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CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

September 11th, 2014

Is This Trial Ethical?

Last month, an article appeared in The Telegraph (U.K.) describing a randomized trial in which cardiac arrest patients will be assigned to receive epinephrine or placebo during resuscitation.

Current ALCS guidelines contain a Class IIb, level A recommendation for administration of epinephrine for sustained VF and PEA/asystole but acknowledge that although epinephrine treatment has been demonstrated to increase rates of return of spontaneous circulation, it has not been shown to improve long-term survival.

This is not the first time epinephrine and placebo have been compared in a randomized trial; results of such a trial appeared in Resuscitation in 2011. Nonetheless, the new trial appears to have sparked ethical concerns about its delayed-consent procedure.

What do you think? Would you support such a trial in your EMS system?

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