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SMACC19 - Aidan Baron on OHCA Trials
- 2. 8014 4015 3999 1457 468 Adrenaline Saline Enrolled ROSC Alive at 30 Days 94130 121 86Alive at 3 Months
- 3. 8014 2.2% 87/4007 1.9% 74/3994 Adrenaline Saline survival to discharge with good neurological outcomes (mRS 0-3) 31.0% 17.8% severe neurological injury at discharge
- 4. Adrenaline in OHCA did not result in significantly more survivors with good outcomes
- 5. 95%
- 7. Airways -2 9296 Patients UK LMA vs ETI as Initial Airway Primary Outcome: mRS at 30 days or discharge Benger et al JAMA 2018
- 8. PART – Pragmatic Airway Resuscitation Trial 3004 Adult Patients USA LT vs ETI Primary Outcome: Survival @ 72 Hours Wang et al JAMA 2018
- 9. CAAM– Cardiac Arrest Airway Management 2043 Patients France & Belgium ETI vs BMV Primary Outcome: CPC at 28 Days Jabre et al JAMA 2018
- 12. CAAM
- 13. 15.4 6.8 4.2 18.3 6.4 4.3 0 2 4 6 8 10 12 14 16 18 20 PART Airways-2 CAAM PRIMARY OUTCOME ETI Alternative Survival 72 Hrs mRS 0-2 @ 30 Days CPC 1-2 @ 28 Days
- 14. There is No Benefit to Routine Endotracheal Intubation for OHCA as a Primary Airway Strategy
- 17. @Aidan_Baron
Editor's Notes
- Should we give adrenaline in OHCA? Paramedic 2, the successor to the PARAMEDIC trial – the rct of mechanical CPR showing no benefit over conventional manual CPR, was published in the new England journal late last year. Based in the UK and conducted across multiple ambulance services, this mammoth study enrolled 8,014 patients and randomised them to either receive adrenaline or a saline placebo as part of conventional advanced life support.
- The future of prehospital resuscitation will be defined not by our outcomes, but by our values as a society As a paramedic, I am not concerned by the perception that we are “loosing skills” because this is not a loss. We are cutting away the dead material to make way for advanced, evidenced based interventions that future clinicians will use to actually benefit patients.
- The future of prehospital resuscitation will be defined not by our outcomes, but by our values as a society As a paramedic, I am not concerned by the perception that we are “loosing skills” because this is not a loss. We are cutting away the dead material to make way for advanced, evidenced based interventions that future clinicians will use to actually benefit patients.