{"id":44757,"date":"2014-09-11T07:52:48","date_gmt":"2014-09-11T11:52:48","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=voices&#038;p=44757"},"modified":"2014-09-11T07:52:48","modified_gmt":"2014-09-11T11:52:48","slug":"is-this-trial-ethical","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2014\/09\/11\/is-this-trial-ethical\/","title":{"rendered":"Is This Trial Ethical?"},"content":{"rendered":"<p>Last month,<a href=\"http:\/\/www.telegraph.co.uk\/health\/healthnews\/11028692\/Heart-patients-to-be-given-placebo-by-paramedics-in-controversial-trial.html\"> an article appeared in<em> The Telegraph<\/em> (U.K.)<\/a> describing <a href=\"http:\/\/www.controlled-trials.com\/ISRCTN73485024\/\">a randomized trial<\/a> in which cardiac arrest patients will be assigned to receive epinephrine or placebo during resuscitation.<\/p>\n<p><a href=\"http:\/\/circ.ahajournals.org\/content\/122\/18_suppl_3\/S729.full#sec-25\">Current ALCS guidelines<\/a> 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.<\/p>\n<p>This is not the first time epinephrine and placebo have been compared in a randomized trial; <a href=\"http:\/\/www.resuscitationjournal.com\/article\/S0300-9572%2811%2900405-9\/abstract\">results of such a trial appeared in<em> Resuscitation<\/em> in 2011<\/a>. Nonetheless, the new trial appears to have sparked ethical concerns about its delayed-consent procedure.<\/p>\n<p><strong>What do you think? Would you support such a trial in your EMS system?<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Does the need for a new placebo-controlled trial of epinephrine in cardiac arrest justify questionable consent procedures?<\/p>\n","protected":false},"author":343,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[2336,317,1897,637,242],"class_list":["post-44757","post","type-post","status-publish","format-standard","hentry","category-general","tag-advanced-cardiac-life-support","tag-cardiac-arrest","tag-epinephrine","tag-informed-consent","tag-resuscitation"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/44757","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/343"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=44757"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/44757\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=44757"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=44757"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=44757"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}