Administrating life-saving drugs for cardiac arrest directly into the bone does not improve survival rates compared to the standard intravenous (IV) method according to new research from The University of Warwick in partnership with NHS Ambulance Services.
Every year in the UK, over 30,000 individuals experience sudden cardiac arrest, with survival depending heavily on immediate, effective treatment.
Current guidelines advise paramedics to inject drugs into a vein, which can take several minutes before drugs can be administered. An alternative way (intraosseous (IO)) is to give drugs through a needle placed in an arm or leg bone.
The use of this alternative approach has been increasing in ambulance services globally with some studies suggesting it might allow drugs to be given more quickly, but there was uncertainty as to whether it would increase the number of patients that survived following cardiac arrest.
The PARAMEDIC-3 trial was funded by the National Institute for Health and Care Research (NIHR). It was conducted by ten NHS ambulance services and one air ambulance service across England and Wales to determine if injecting drugs directly into a bone could provide a faster and potentially more effective alternative to intravenous administration.
Dr Keith Couper, Co-Chief Investigator from The University of Warwick says, "The findings of the PARAMEDIC-3 study will be extremely important in informing how we treat adult cardiac arrest patients in the future. The results clearly show that giving life-saving cardiac arrest drugs in to a bone rather than into a vein does not save more lives following cardiac arrest."
The study randomly assigned 6,082 adult cardiac arrest patients to receive drugs through either the bone (intraosseous) or vein (intravenous) routes.
Key Findings of PARAMEDIC-3 Trail
- Time of Drug Delivery: The study found no significant difference in the time required to administer drugs using the intraosseous or intravenous route.
- Survival and Neurological Outcomes: Patients in both the intraosseous and intravenous groups showed similar outcomes, with no significant differences in the rates of survival at 30 days or neurological recovery.
The PARAMEDIC-3 study results indicate that injecting drugs into the bone does not improve survival or outcomes in cardiac arrest patients compared to traditional IV drug administration.
Throughout the study, a dedicated patient advisory group helped shape the project, ensuring public and patients were informed of the study processes and decisions. Ongoing follow-ups are now exploring patient recovery in the months following cardiac arrest to assess longer-term outcomes.
Professor Gavin Perkins, Co-Chief Investigator from The University of Warwick says, "The UK has established a strong track record in delivering world-leading ambulance service research that improves the care and treatment of the patients that they serve. We would like to thank both the patients and the ambulance services who participated in PARAMEDIC3."
Funded by the NIHR, the findings of this large-scale study will inform international clinical guidelines on the most effective emergency drug administration methods for cardiac arrest patients.
The full study can be found here.
