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.

ENDS

Notes to Editors

The University of Warwick is one of the UK’s leading universities with over twenty-eight thousand students from 147 countries. Ranked 9th in the UK by The Guardian University Guide, it has an acknowledged reputation for excellence in research and teaching, for innovation, and for links with business and industry. The recent Research Excellence Framework classed 92% or it’s research as ‘world leading’ or ‘internationally excellent’. The University of Warwick was awarded University of the Year for Teaching Quality by The Times and Sunday Times.

About the National Institute for Health and Care Research (NIHR):

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

• Funding high quality, timely research that benefits the NHS, public health and social care;

• Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;

• Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;

• Attracting, training and supporting the best researchers to tackle complex health and social care challenges;

• Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;

• Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK international development funding from the UK government.