The objective of this randomized controlled trial is to evaluate whether a low cumulative dose of epinephrine ("low dose") is non-inferior to a standard cumulative dose of epinephrine ("standard dose") with respect to survival to hospital discharge among adults undergoing resuscitation for OHCA due to ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT).
Out-of-hospital cardiac arrest treated by paramedics AND
Initial recorded cardiac rhythm of VF or pulseless VT, or, AED shock on first analysis administered or confirmed by paramedics or fire services, AND
Established intravenous vascular access
Known or apparent age <18 years
Initial recorded cardiac rhythm of VF or pulseless VT, or, AED shock on first analysis administered or confirmed by paramedics
Cardiac arrest due to an obvious non-cardiac primary cause (e.g. blunt or penetrating trauma, exsanguination, burns, drug overdose, drowning, anaphylaxis, sudden asphyxiation, etc.)
Administration of intramuscular, endotracheal tube, or intraosseous epinephrine
Parallel
Epinephrine
DrugEpinephrine 1mg 1:10000 (10cc) per dose
Survival to hospital discharge
Individuals discharged alive from hospital
Return of spontaneous circulation in out-of-hospital setting
Return of spontaneous circulation in the field
Survival to emergency department arrival
Individuals alive upon arrival to a hospital emergency department
Survival to admission with death prior to discharge
Individuals alive upon hospital admission who die in-hospital before being discharged
Survival to discharge outside of a long-term healthcare facility e.g. nursing home
Individuals discharged alive from hospital to a care facility
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Unity Health Toronto
Lead sponsor
Canadian Institutes of Health Research (CIHR)
Collaborator
