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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