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Pre-hospitAl RAndomised trial of MEDICation route in out-of-hospital cardiac arrest (PARAMEDIC-3)

The PARAMEDIC-3 trial is looking at the most effective way to treat someone when their heart suddenly stops working out of hospital by giving drugs through a vein or into the bone. Answering this question will help to improve future treatment of people who have a cardiac arrest.

Key information:

Chief Investigator: Professor Gavin Perkins

Sponsor: University of Warwick

Funder: National Institute for Health Research HTA programme (NIHR131105)

Registration Number: ISRCTN14223494


Each year over 30,000 people’s hearts suddenly stop beating in communities around the UK (a condition known as out-of-hospital cardiac arrest). Giving drugs, such as adrenaline, is very effective at restarting the heart. However, for many people drugs are given too late to save them. This partly explains why less than one in ten people survive an out of hospital cardiac arrest. 

Current guidelines advise paramedics to inject drugs into a vein. It can take several critical minutes to put a drip in to a vein, ready to give drugs. A faster way to give drugs is to put a small needle into an arm or leg bone. This allows drugs to be given directly into the rich blood supply found in the bone marrow.

None of the existing research is good enough to help paramedics know which of these is the best way to give drug treatments. The aim of the trial is to find out if giving drugs through a vein or into the bone is the most effective way to treat someone when their heart suddenly stops working and whether it makes a difference to how well people recover after cardiac arrest.

We plan to test whether injecting drugs into the vein or the bone is most effective. NHS paramedics in England and Wales will recruit 15,000 patients to the trial- half will receive drugs given into the bone and half will receive drugs given into the vein. This will be decided by chance. This is known as a randomised controlled trial, and is the best way of finding out which treatment is most effective.

We will follow-up patients that survive their cardiac arrest to see how they well they recover from their cardiac arrest.

Sample size:

15,000 out-of-hospital cardiac arrest patients

Primary outcome:

Survival at 30 days


01 April 2021 - 31 March 2025

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Please direct all enquiries for the PARAMEDIC-3 trial team.

Telephone: 07385029213

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