PubHawk
N Engl J Med August 2018 PMID 30021076

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest.

Gavin D Perkins, Chen Ji, Charles D Deakin, Tom Quinn, Jerry P Nolan, Charlotte Scomparin, Scott Regan, John Long, Anne Slowther, Helen Pocock, John J M Black, Fionna Moore, Rachael T Fothergill, Nigel Rees, Lyndsey O'Shea

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Mentions

296
Peak: 14 in Jun 2022
across 7 sources since Jul 2018

Extended reach

801,155
potential audience

Total likes

797

Video views

16,274

Mentions per month

Jul 2018 – Aug 2025

Where it's discussed

  • X / Twitter123 posts
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  • Bluesky6 posts
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  • YouTube4 videos

AI synopsis

What people are saying

The discussions highlight the nuanced effects of epinephrine, with posts mentioning increased ROSC and 30-day survival but also worse neurological outcomes, using words like 'challenged dogma' and 'controversial,' which reflect both engagement and concern about the implications for practice and patient quality of life.

AgreementModerate agreement

Most discussions acknowledge that while epinephrine increases short-term survival, it does not improve long-term neurological outcomes, showing cautious agreement.

InterestHigh interest

There is a high level of interest in the trial's results and implications, with many engaging with detailed analyses and questioning guidelines.

EngagementHigh engagement

Discussions reference clinical trials, outcomes, and ethical considerations, indicating deep engagement with the study's findings.

ImpactModerate impact

The debate around the balance of survival and neurological impairment suggests moderate impact on current medical practices, though some argue for reevaluation of standard protocols.

Abstract in brief

  • The trial found that administering epinephrine during out-of-hospital cardiac arrests increased the overall 30-day survival rate compared to a placebo, but there was no significant difference in the number of patients with good neurological outcomes after recovery.
  • More patients in the epinephrine group survived to hospital discharge but experienced more severe neurological impairments, suggesting that while epinephrine may help more people survive, it might also increase the risk of significant brain injury.
  • The study highlights the need to weigh the benefits of increased survival against the potential for worse neurological recovery when considering epinephrine as a treatment during cardiac emergencies outside the hospital.
Read the full abstract

Top posts

Most liked on X and Bluesky
Jeff Jarvis
@DrJeffJarvis · X

I feel I’m WAY overdue with this meme. I mean, someone had to do it. Context: Perkins GD, Ji C, Deakin CD, et al. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2018;379(8):711-721. doi:10.1056/NEJMoa1806842 https://t.co/e2zg0SNQSV

Apr 18, 2022 · 40 likes · 5 shares · 5,739 followers View post →
Shannon Fernando
@shanfernands · X

We pursued this work in the context of the PARAMEDIC-2 trial, published in @NEJM in 2018. https://t.co/GKjt2CpV1v PARAMEDIC-2 found that epinephrine improved 30-day survival, but also found no improvement in survival with good functional outcomes (a secondary outcome). https://t.co/R8VSxZz4TX

Feb 2, 2023 · 21 likes · 1,198 followers View post →
Tony Breu
@tony_breu · X

6/ What about neurologic outcomes? Rates of survival with favorable neurologic outcomes were no different: ➤2.2% epinephrine ➤1.9% placebo But, rates of severe neurologic impairment were higher in the epinephrine arm: ➤31% epinephrine ➤18% placebo https://t.co/HNRMb2TYuo https://t.co/3X6TFDVe9S

Jun 12, 2022 · 12 likes · 83,410 followers View post →
ACCP EMED PRN
@accpemedprn · X

Let's kick off our fave pre-hospital trials for this #EMSWeek2020: First up is #PARAMEDIC2! Well designed and executed to answer a challenging question - does epi improve outcomes in #OHCA? Still generating discussion 2 years later https://t.co/Dh9Cp8UliK

May 19, 2020 · 12 likes · 2 shares · 5,449 followers View post →
Intensive Care Society
@ICS_updates · X

PARAMEDIC-2: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest - Gavin Perkins https://t.co/MB2YeORR7g https://t.co/GoDthQlfym

Jan 9, 2019 · 11 likes · 7 shares · 40,012 followers View post →
集中治療クラブ
@intensivecare_c · X

院外心停止に対して、エピネフリン vs プラセボを比較したPARAMEDIC2はこちら。 https://t.co/0lFlouqrci

Jan 30, 2020 · 11 likes · 5 shares · 13,507 followers View post →

All mentions

Damien BARRAUD MD
@damienbarraudmd.bsky.social · Bluesky

d'autre que ramener plus de vivants à l'hôpital, mais n'améliorait pas le pronostic à long terme dans PARAMEDIC 2 évoqué plus haut...vous avez un peu plus de "vivants". Mais ils sont dans de très piteux états neurologiques...Soit parce que vous avez fait repartir pubmed.ncbi.nlm.nih.gov/30021076/

Aug 1, 2025 · 2 likes · 1 share View post →
Caz Sampson
@caz_sampson · X

@KateShemirani 3. PARAMEDIC-2 results can be found here. The study write up does not include the quote “Patients could only be included if organ donation was possible post-resuscitation.” Please can you explain where that comes from (the link provided does not work) https://t.co/E4yPqtvph2

Jul 12, 2025 · 3,308 followers View post →
Lou
@LouiseCant4 · X

Read this carefully @BBCPanorama https://t.co/AijWHutaqZ https://t.co/TUWjANBJpq

Jul 11, 2025 · 799 followers View post →
Lou
@LouiseCant4 · X

Good God @wesstreeting how is this possible- it’s beyond monstrous https://t.co/AijWHutaqZ https://t.co/TUWjANBJpq

Jul 11, 2025 · 799 followers View post →
Caz Sampson
@caz_sampson · X

@UnityNewsNet @KateShemirani Probably important for Mr McCrae (and anyone else who is interested) to actually read the results from the Paramedics 2 trial rather than relying on others’ interpretations. Here it is https://t.co/inVi2pyHU7

Jul 11, 2025 · 6 likes · 3,308 followers View post →
Caz Sampson
@caz_sampson · X

@LaceDeb @TaniLinton @KateShemirani That it significantly increases survival in out of hospital cardiac arrest from the paramedic 2 trial? https://t.co/inVi2pzfJF

Jul 10, 2025 · 3 likes · 3,308 followers View post →
Turlach O’Bartlett
@BerryTartlet · X

@Nullen80 of organ transplantation in this trial. https://t.co/6t5b9JaQbp

Jun 30, 2025 · 1,930 followers View post →
Caz Sampson
@caz_sampson · X

@aunty_vax @rdt55555 @angelalake @GabrielCyShemi Paramedic 2 shows that your chances of surviving 30d were statistically less if you didn’t receive adrenaline whilst in cardiac arrest. You can read the trial results here https://t.co/inVi2pyHU7

Jun 28, 2025 · 3 likes · 3,308 followers View post →
Fokker Films
@FloraBr79074860 · X

...is full of narcissists. I am not saying that Shimirani is another one but I wouldn't be surprised to learn that she was. As for Shimirani's allegations. The Paramedic 2 and 3 trials out of Warwick did happen and are underway respectively. https://t.co/6aAYmpJ7ud

Jun 25, 2025 · 613 followers View post →
Damien BARRAUD MD
@damienbarraudmd.bsky.social · Bluesky

Yes but... The survival rate are the same as when I was a student... pubmed.ncbi.nlm.nih.gov/30021076/

May 17, 2025 View post →
Tellit Likeitis
@Tellit007 · X

@structureltp @MichaelMindrum @BudoffMd @realDaveFeldman @realCSF @the_lundquist "Effect of Hydroxychloroquine in Hospitalized Patients with COVID-19" "Surgisphere COVID-19 Studies" "A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest" (Note: criticized, not retracted, for outcome reporting issues)

Apr 24, 2025 · 155 followers View post →
Dr Scorpion the Bird, secret FBI Informant
@scorpion_bird · X

@Rcub1721 https://t.co/zKolaqDs6U)%20(Table%203).

Mar 21, 2025 · 1,348 followers View post →
Jon Rogers
@RogersJon2 · X

@KateShemirani 3/4 They also note in their discussion that public consultation “identified survival with a favorable neurologic outcome to be a higher priority than survival alone.” See DOI: 10.1056/NEJMoa1806842

Mar 4, 2025 · 521 followers View post →
Renais_Fの覚え書き
@Renais_Med · X

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest | New England Journal of Medicine https://t.co/wRBp3zHsq0

Jan 24, 2025 · 7 followers View post →
Ken Milne MD
@TheSGEM · X

@fortybam @ross_prager @IM_Crit_ @NephroP @EM_RESUS @PulmCrit @emcrit @katiewiskar @nickmmark Severe neurologic impairment (mRS 4 or 5) was more common among survivors in the epinephrine groups compared to the placebo group (31.0% vs. 17.8%). https://t.co/CoC7cb1HbG @NEJM

Dec 3, 2024 · 1 like · 28,201 followers View post →
Keith Couper
@KeithCouper · X

Why did we do PARAMEDIC-3? Our starting point- drugs in cardiac arrest do work. In PARAMEDIC-2, adrenaline had a huge effect on ROSC- it ⬆️increases the odds of achieving ROSC by 3⃣. The effect on 30-day survival is smaller but still important. https://t.co/mvc3hnjc0m (2/n)

Nov 7, 2024 · 11 likes · 1,006 followers View post →
Neurocritical Care University
@Neurocrit_univ · X

心停止蘇生後の低酸素脳症6

Nov 7, 2024 · 2 likes · 670 followers View post →
Yohei Okada
@OkadaYohei · X

@lE9BrvyUwLLVZIE https://t.co/6zBiqZAgDB そうですね、そんな感じです

Nov 1, 2024 · 2,226 followers View post →
Emergency Medicine Evidence
@emevidence49813 · X

PARAMEDIC-2: Adrenaline given during cardiac arrest does not increase survival with favourable neurological outcome and produces more survivors with severe neurologic impairment https://t.co/F47gQCxiT4 https://t.co/k8ryWKJMcD

May 30, 2024 · 1 followers View post →
Andy Johnston
@armycritcare · X

@CatherineCounts @slcfire I guess it’s congruent with Paramedic 2, though with better survival https://t.co/ARNZon1z8i

Nov 13, 2023 · 4,138 followers View post →
ローレライ
@usagii124 · X

RT @yotsumex: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest | NEJM https://t.co/UMTPA0na4b 現場レベルではアドレナリンの効果を肌感覚として感じ…

Nov 5, 2023 · 2 shares · 1,029 followers View post →
yotsumex
@yotsumex · X

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest | NEJM https://t.co/UMTPA0na4b 現場レベルではアドレナリンの効果を肌感覚として感じることができないのは、30日生存を達成するための治療必要数ーNNT(number needed to treat)ーが112だからです。

Nov 5, 2023 · 6 likes · 2 shares · 683 followers View post →
Lisa Rossbach
@lisasEMworld · X

@davidcarr333 @sadiyeayhan Totally agree! Paramedic2 (2018) told us already, but „for some reason“ didn’t make it into the guidelines

Sep 20, 2023 · 1 like · 612 followers View post →
Matt Sztajnkrycer
@NoobieMatt · X

@CARE_1975 @NYCEMSwatch And probably not epinephrine. Sure you get ROSC but the end outcome may be worse. As you note, BLS is the key. https://t.co/am6YPlzqjh

Aug 27, 2023 · 7,410 followers View post →
Richard Cashmore
@RMJCashmore · X

OHCA/IHCA/Peri-arrest/low flow states In need of some RCT diagnostic/managerial refinement. Will be challenging. Carotid Pulse https://t.co/YY5xQzBDah Paramedic2 https://t.co/LAMugWo4a4 All or nothing still

Aug 12, 2023 · 264 followers View post →
Pharmacy To Dose: The Critical Care Podcast
@PharmacyToDose · X

#TrialOfTheDay for July 18th is the PARAMEDIC2 trial, published ahead of print on this date in 2018 in @NEJM Demonstrating efficacy for epinephrine in out-of-hospital cardiac arrest Open-access article link: https://t.co/yU8TpiGrSz #pharmicu #pharmem #ems #emrx #twitterx https://t.co/lUpWqFiTw3

Jul 18, 2023 · 6,819 followers View post →
Teddy Hla
@teddyhla · X

@tamishtah Paramedic 2(2018) study of adrenaline vs. placebo: but lets look at it for times. 999 arrival 6.6 mins, 30-day survival 3.2% (intervention) vs. 2.4% (control) https://t.co/1gelnotpFz

Jun 19, 2023 · 1,518 followers View post →
Dr. rer. nat. W. Meier-Augenstein, FRSC
@WolfmannotJack · X

@wolfhautz @hellfridge1 Hierzu dies

Feb 23, 2023 · 3 likes · 3,811 followers View post →
Tanner Smida
@TannerSmida · X

@Old_stoneface31 PARAMEDIC2 - 10.1056/NEJMoa1806842 EPIC - 10.1001%2Fjamasurg.2019.1152 PART - 10.1001%2Fjama.2018.7044 AIRWAYS 2 - 10.1001/jama.2018.11597 CAAM - 10.1001/jama.2018.0156 DSED - 10.1056/NEJMoa2207304 ALPS - 10.1056/NEJMoa1514204 CRASH 2 - 10.3310/hta17100

Feb 8, 2023 · 1 like · 294 followers View post →
Shannon Fernando
@shanfernands · X

We pursued this work in the context of the PARAMEDIC-2 trial, published in @NEJM in 2018. https://t.co/GKjt2CpV1v PARAMEDIC-2 found that epinephrine improved 30-day survival, but also found no improvement in survival with good functional outcomes (a secondary outcome). https://t.co/R8VSxZz4TX

Feb 2, 2023 · 21 likes · 1,198 followers View post →
Philippe Guerci MD,PhD
@PhilGuerci · X

@____Dopamine___ Je conçois que ce soit variable car j ai fait un peu de samu. Néanmoins c est bien plus la pression des habitudes qu un vrai rationnel hormis le patient incarcéré comme dit avant. Je vous donne un exemple illustratif https://t.co/HF8UNSc1AM Les certitudes sont discutables

Jan 14, 2023 · 281 followers View post →
Javier Casas Rodríguez
@casita1981 · X

RT @teddyhla: @ESICM PARAMEDIC 2 - big study 8007 pts, adrenaline 4000, placebo 3999 - a lot of discussion post trial - need a nuanced int…

Oct 25, 2022 · 2 shares · 374 followers View post →
Adrian Wong
@avkwong · X

RT @teddyhla: @ESICM PARAMEDIC 2 - big study 8007 pts, adrenaline 4000, placebo 3999 - a lot of discussion post trial - need a nuanced int…

Oct 25, 2022 · 2 shares · 12,554 followers View post →
Teddy Hla
@teddyhla · X

@ESICM PARAMEDIC 2 - big study 8007 pts, adrenaline 4000, placebo 3999 - a lot of discussion post trial - need a nuanced interpretation. - 19 "more good" survivors and 5 "more bad" survivors in adrenaline arm. https://t.co/1gelnotpFz

Oct 25, 2022 · 5 likes · 2 shares · 1,518 followers View post →
Steve Gill
@ICMdoc · X

The paramedic2 trial being described by Gavin Perkins #SOA22 https://t.co/jZBlaohy4Z

Jul 1, 2022 · 1 like · 4,344 followers View post →
Xavier Gómez Herrera
@XAVIGP1 · X

RT @MUE_14: .@rvarel Adrenalina en PCR: - mejora ROSC - no mejora sobrevida neurologicamente intacto ¿Será momento de sacarla de los algo…

Jun 25, 2022 · 6 shares · 241 followers View post →
Sergio Alvizu
@salvizu_MUE · X

RT @MUE_14: .@rvarel Adrenalina en PCR: - mejora ROSC - no mejora sobrevida neurologicamente intacto ¿Será momento de sacarla de los algo…

Jun 25, 2022 · 6 shares · 2,380 followers View post →
eMUE
@MUE_14 · X

RT @MUE_14: .@rvarel Adrenalina en PCR: - mejora ROSC - no mejora sobrevida neurologicamente intacto ¿Será momento de sacarla de los algo…

Jun 25, 2022 · 6 shares · 4,872 followers View post →
michel rey
@michelereyhdez · X

RT @MUE_14: .@rvarel Adrenalina en PCR: - mejora ROSC - no mejora sobrevida neurologicamente intacto ¿Será momento de sacarla de los algo…

Jun 25, 2022 · 6 shares · 2,367 followers View post →
Dafne Benavides
@Dafnebenavidesv · X

RT @MUE_14: .@rvarel Adrenalina en PCR: - mejora ROSC - no mejora sobrevida neurologicamente intacto ¿Será momento de sacarla de los algo…

Jun 25, 2022 · 6 shares · 902 followers View post →
Pablo Flores
@pablofjerez · X

RT @MUE_14: .@rvarel Adrenalina en PCR: - mejora ROSC - no mejora sobrevida neurologicamente intacto ¿Será momento de sacarla de los algo…

Jun 25, 2022 · 6 shares · 85 followers View post →
eMUE
@MUE_14 · X

.@rvarel Adrenalina en PCR: - mejora ROSC - no mejora sobrevida neurologicamente intacto ¿Será momento de sacarla de los algoritmos?

Jun 25, 2022 · 8 likes · 6 shares · 4,872 followers View post →
Edgie M.
@lyfedge · X

RT @tony_breu: 4/ This was followed by a 2018 randomized, placebo-controlled trial. It included 8014 patients with out-of-hospital cardiac…

Jun 12, 2022 · 1 share · 29 followers View post →
Tony Breu
@tonybreu.bsky.social · Bluesky

placebo https://pubmed.ncbi.nlm.nih.gov/30021076/

Jun 12, 2022 · 1 share View post →
Tony Breu
@tony_breu · X

6/ What about neurologic outcomes? Rates of survival with favorable neurologic outcomes were no different: ➤2.2% epinephrine ➤1.9% placebo But, rates of severe neurologic impairment were higher in the epinephrine arm: ➤31% epinephrine ➤18% placebo https://t.co/HNRMb2TYuo https://t.co/3X6TFDVe9S

Jun 12, 2022 · 12 likes · 83,410 followers View post →
Tony Breu
@tony_breu · X

5/ The rates of return of spontaneous circulation (ROSC) were significantly higher in the epinephrine arm: ➤36% epinephrine ➤12% placebo 30-day survival was also higher in the epinephrine arm: ➤3.2% epinephrine ➤2.4% placebo https://t.co/HNRMb2TYuo https://t.co/Ak9w4dAuxj

Jun 12, 2022 · 10 likes · 1 share · 83,410 followers View post →
Tony Breu
@tonybreu.bsky.social · Bluesky

5/ The rates of return of spontaneous circulation (ROSC) were significantly higher in the epinephrine arm: ➤36% epinephrine ➤12% placebo 30-day survival was also higher in the epinephrine arm: ➤3.2% epinephrine ➤2.4% placebo https://pubmed.ncbi.nlm.nih.gov/30021076/

Jun 12, 2022 · 1 share View post →
Tony Breu
@tony_breu · X

4/ This was followed by a 2018 randomized, placebo-controlled trial. It included 8014 patients with out-of-hospital cardiac arrest. Patients received either epinephrine or a saline placebo. https://t.co/HNRMb2TYuo https://t.co/B3T5INsSKk

Jun 12, 2022 · 8 likes · 1 share · 83,410 followers View post →
Tony Breu
@tonybreu.bsky.social · Bluesky

4/ This was followed by a 2018 randomized, placebo-controlled trial. It included 8014 patients with out-of-hospital cardiac arrest. Patients received either epinephrine or a saline placebo. https://pubmed.ncbi.nlm.nih.gov/30021076/

Jun 12, 2022 · 1 share View post →
Pierre Arbulú
@mtd98 · X

RT @DrJeffJarvis: I feel I’m WAY overdue with this meme. I mean, someone had to do it. Context: Perkins GD, Ji C, Deakin CD, et al. A Ran…

Apr 19, 2022 · 5 shares · 706 followers View post →
Cris Polma
@CrisPolma · X

RT @DrJeffJarvis: I feel I’m WAY overdue with this meme. I mean, someone had to do it. Context: Perkins GD, Ji C, Deakin CD, et al. A Ran…

Apr 19, 2022 · 5 shares · 864 followers View post →
Manrique Umana McDermott
@umanamd · X

RT @DrJeffJarvis: I feel I’m WAY overdue with this meme. I mean, someone had to do it. Context: Perkins GD, Ji C, Deakin CD, et al. A Ran…

Apr 19, 2022 · 5 shares · 12,113 followers View post →
Tom Bouthillet
@tbouthillet · X

RT @DrJeffJarvis: I feel I’m WAY overdue with this meme. I mean, someone had to do it. Context: Perkins GD, Ji C, Deakin CD, et al. A Ran…

Apr 18, 2022 · 5 shares · 8,004 followers View post →
Lance Peeples
@PeeplesLance · X

RT @DrJeffJarvis: I feel I’m WAY overdue with this meme. I mean, someone had to do it. Context: Perkins GD, Ji C, Deakin CD, et al. A Ran…

Apr 18, 2022 · 5 shares · 88 followers View post →
Jeff Jarvis
@DrJeffJarvis · X

I feel I’m WAY overdue with this meme. I mean, someone had to do it. Context: Perkins GD, Ji C, Deakin CD, et al. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2018;379(8):711-721. doi:10.1056/NEJMoa1806842 https://t.co/e2zg0SNQSV

Apr 18, 2022 · 40 likes · 5 shares · 5,739 followers View post →
Fahd Alrumaih ‎ فهد الرميح
@frumaih1 · X

RT @AnesthCritCare: #Epinephrine in Out-of-Hospital Cardiac Arrest #PARAMEDIC2 trial: good to restart the heart but bad for the brain? Epi…

Mar 4, 2022 · 11 shares · 495 followers View post →
Fahd Alrumaih ‎ فهد الرميح
@frumaih1 · X

RT @SayreMR: Prehospital epinephrine at a dose of 1 mg every 3-5 minutes does NOT increase neurologically intact survival from out-of-hospi…

Mar 4, 2022 · 46 shares · 495 followers View post →
Jaymin S Shah
@JayminSShah1 · X

RT @AmirLotfi9: @yeh_james3 @drthangtm https://t.co/ADIiGkOcQN

Nov 17, 2021 · 2 shares · 262 followers View post →
James Yeh
@yeh_james3 · X

RT @AmirLotfi9: @yeh_james3 @drthangtm https://t.co/ADIiGkOcQN

Nov 16, 2021 · 2 shares · 5,303 followers View post →
Amir Lotfi
@AmirLotfi9 · X

@yeh_james3 @drthangtm https://t.co/ADIiGkOcQN

Nov 16, 2021 · 4 likes · 2 shares · 392 followers View post →
Stu Woolley
@Northernmedic · X

RT @ACParamedicine: The Paramedic 2 Trial - A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest - is one of the RTCs which…

Nov 5, 2021 · 3 shares · 1,263 followers View post →
Ali.Al.Barry
@alialbarry1 · X

RT @ACParamedicine: The Paramedic 2 Trial - A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest - is one of the RTCs which…

Nov 5, 2021 · 3 shares · 107 followers View post →
Australasian College of Paramedicine (ACP)
@ACParamedicine · X

The Paramedic 2 Trial - A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest - is one of the RTCs which our #TalkingResearch guests Helen Pocock & Tom Quinn have been involved with. Interested in learning more? Join us online on November 10 https://t.co/oUTH37sAvZ https://t.co/xiymXdSKez

Nov 5, 2021 · 3 likes · 3 shares · 2,995 followers View post →
Ken Milne MD
@TheSGEM · X

@4mmk36 @emlitofnote @First10EM Similar arguments were made about lack of equipoise & near impossibility to conduct an RCT on epinephrine for OHCA. Epinephrine is part of ACLS algorithm and supported by many guidelines including the AHA. Yet the study was done. https://t.co/CIjgc044Ri

Oct 12, 2021 · 28,201 followers View post →
Wil Gibb, MD
@Wil_Gibb · X

@macwalterMD @CritCareReviews There's a great review of evidence of epi in arrest, and then the PARAMEDIC-2 trialp published after the review, also showing increased ROSC but worse neurologic outcomes. https://t.co/JUWXDc5at8 https://t.co/qEAQNSGnOF

Oct 1, 2021 · 1,461 followers View post →
Rhazelovitch
@Rhazelovitch · X

@R3cklinghausen https://t.co/qNHH4cTROZ Oui. Mais de l’outcome clinique qui ne rend pas forcément service au patient et à sa vie future.

Sep 30, 2021 · 6,516 followers View post →
Guna Seelan
@drrigs08 · X

RT @DavidZodda: The number needed to treat (NNT) to prevent one death after cardiac arrest. Courtesy of the PARAMEDIC2 Trial. - Early Defi…

Sep 16, 2021 · 42 shares · 177 followers View post →
Wendy Burn CBE (She/her)
@wendyburn · X

@DrAnkushSinghal You are absolutely right. I was shocked too. I don’t know if the relatives of the dead people who were given placebo were ever told. https://t.co/b4TggI8vsn

Sep 3, 2021 · 27,269 followers View post →
こどぶ
@codeblueflower · X

@kRYNu54oWVZUH6c これを読んでどう思うかです A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest https://t.co/NLPCZiCtLM

Aug 23, 2021 · 4 likes · 10,780 followers View post →
Manuela Brinkmann
@manu_brinkmann · X

5/ #paramedic2 trial (2018)

Jul 27, 2021 · 1 like · 1,366 followers View post →
Cody Cunningham, MD, PhD
@CunninghamResus · X

Today is a good reminder that all other interventions are secondary to high-quality CPR and early defibrillation in OHCA (from: https://t.co/mCecC2WBZx) https://t.co/UJkvBxBVxM

Jun 12, 2021 · 410 followers View post →
Champo
@ChampoDr · X

@DIntubator Bon on fait les malins mais l'adrénaline fait pas mieux comme outcome à un mois d'un ACR contre un placebo. https://t.co/eXQj6XKU3c

Jun 8, 2021 · 2 likes · 12,145 followers View post →
Amy Raubenolt
@buckeyeEMSdoc · X

RT @DrJeffJarvis: I’m thinking about PARAMEDIC2 again tonight. 0.8% improved 30 day survival w/o improved neuro survival and 13% more neu…

Apr 30, 2021 · 3 shares · 192 followers View post →
Firstname Bunchanumbers
@GregDeMatteo · X

RT @DrJeffJarvis: I’m thinking about PARAMEDIC2 again tonight. 0.8% improved 30 day survival w/o improved neuro survival and 13% more neu…

Apr 29, 2021 · 3 shares · 311 followers View post →
Jeff Jarvis
@DrJeffJarvis · X

I’m thinking about PARAMEDIC2 again tonight. 0.8% improved 30 day survival w/o improved neuro survival and 13% more neuro devastation among survivors. NNT 112 for survival vs 5 for early defib. 0% probability of at least 2% neuro survival. 1/2 https://t.co/noBas79qNW

Apr 29, 2021 · 9 likes · 3 shares · 5,739 followers View post →
Ravi Mangal Patel
@ravimpatelmd · X

@BrianKingNeo @DrAbdulRazak_MD @rehman_naveed @adrisdoc @AAPneonatal @EBNEO @souvik_neo @NeoTECaN @neosatyan @waseemoddin @NielsRochow Researchers asked this question in adults a half century after epi use became part of routine practice and subjected it to rigorous scrutiny https://t.co/UT8K559p0u

Apr 3, 2021 · 2 likes · 4,573 followers View post →
Yniki(Yニキ)
@evidence_Yniki · X

https://t.co/cxMrcuEOb8

Mar 28, 2021 · 1 like · 182 followers View post →
Yniki(Yニキ)
@evidence_Yniki · X

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2018 Aug 23;379(8):711-721. doi: 10.1056/NEJMoa1806842. Epub 2018 Jul 18. PMID: 30021076.

Mar 28, 2021 · 182 followers View post →
Paul Gowens QAM
@PaulGowens · X

RT @TheSGEM: PICO from this RCT on epinephrine for OHCA. https://t.co/CoC7cb1HbG @NEJM @JWatch https://t.co/IIac5wAFQ8

Feb 26, 2021 · 1 share · 4,635 followers View post →
Ken Milne MD
@TheSGEM · X

PICO from this RCT on epinephrine for OHCA. https://t.co/CoC7cb1HbG @NEJM @JWatch https://t.co/IIac5wAFQ8

Feb 26, 2021 · 1 share · 28,201 followers View post →
Tommaso Scquizzato, MD
@tscquizzato · X

RT @realscientists: The PARAMEDIC2 trial compared epinephrine (adrenaline) to placebo in OHCA. Epi got more pulses back (ROSC), but those…

Jan 30, 2021 · 1 share · 5,124 followers View post →
RealScientists
@realscientists · X

The PARAMEDIC2 trial compared epinephrine (adrenaline) to placebo in OHCA. Epi got more pulses back (ROSC), but those that survived had worse neurological outcomes at hospital discharge. Trial had overall low survival rate, making generalizability tough. https://t.co/cJwNnSNCZK https://t.co/HfkLu3btQx

Jan 30, 2021 · 5 likes · 1 share · 76,612 followers View post →
Dr K Wildschut OLD AGE Psychiatrist
@DrK_W1984 · X

RT @EmilyIngridST: @wendyburn Not anaphylaxis but related and interesting in case you missed it (can’t read everything!) https://t.co/9wpuZ…

Jan 12, 2021 · 1 share · 3,046 followers View post →
Emily SimonThomas
@EmilyIngridST · X

@wendyburn Not anaphylaxis but related and interesting in case you missed it (can’t read everything!) https://t.co/9wpuZLBRnD and the Resus Room discussion at the time https://t.co/J0uzxJAmR1

Jan 12, 2021 · 5 likes · 1 share · 785 followers View post →
Calum Polwart
@ShinyBlackShoe · X

@MarkGeyerMD @VPrasadMDMPH @Luke1732Mullen Adrenaline in cardiac arrest was always accepted as SoC. The UK were brave enough to run a trial... https://t.co/5OxsGI62Ai No big pharma...

Dec 23, 2020 · 887 followers View post →
ふろりあん
@ems4jhondo · X

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest | NEJM https://t.co/EHzqVXznAv

Nov 23, 2020 · 1,066 followers View post →
Petter Rutter
@critcare4lyf · X

@sargsyanz we could fix the problem if we stop giving Epi in cardiac arrest!

Nov 12, 2020 · 1 like · 73 followers View post →
Yniki(Yニキ)
@evidence_Yniki · X

院外心停止を対象としたエピネフリンのランダム化比較試験 https://t.co/cxMrcuEOb8

Sep 26, 2020 · 1 share · 182 followers View post →
John Clarke
@C7RKY · X

RT @littlepixie3: @C7RKY They were testing to see if adrenaline had an effect on arrest patients in the community. Paramedics were sent out…

Sep 16, 2020 · 1 share · 1,830 followers View post →
AJPMD
@pulmccm2016 · X

RT @CHESTCritCare: Epi is also the first ACLS drug, and has been considered "standard of care" for decades now, several studies have associ…

Aug 19, 2020 · 2 shares · 740 followers View post →
Segun Olusanya (He/Him) iceman_ex@critcare.social
@iceman_ex · X

RT @CHESTCritCare: Epi is also the first ACLS drug, and has been considered "standard of care" for decades now, several studies have associ…

Aug 18, 2020 · 2 shares · 19,589 followers View post →
CHEST Critical Care Network
@CHESTCritCare · X

Epi is also the first ACLS drug, and has been considered "standard of care" for decades now, several studies have associated it with increased rate of ROSC, but more recent evidence not showing better survival. https://t.co/i4Fy3xz1nc

Aug 17, 2020 · 9 likes · 2 shares · 6,132 followers View post →
L'IDG pharma bonsoir!
@idg_pharma · X

@Eska80 @EChabriere https://t.co/kPJDCcQSjn

Jun 25, 2020 · 1,273 followers View post →
andres zapata
@andresparana · X

RT @HansvanSchuppen: #Adrenaline in #resuscitation for cardiac arrest: better for survival but worse for the brain so no increase in good s…

Jun 24, 2020 · 29 shares · 125 followers View post →
Austin Wilson
@Deausticytidine · X

RT @accpemedprn: Let's kick off our fave pre-hospital trials for this #EMSWeek2020: First up is #PARAMEDIC2! Well designed and executed to…

May 20, 2020 · 2 shares · 263 followers View post →
Piotr Golenia, PharmD, BCPS, WXYZ
@Peter_Golenia · X

RT @accpemedprn: Let's kick off our fave pre-hospital trials for this #EMSWeek2020: First up is #PARAMEDIC2! Well designed and executed to…

May 19, 2020 · 2 shares · 329 followers View post →
ACCP EMED PRN
@accpemedprn · X

Let's kick off our fave pre-hospital trials for this #EMSWeek2020: First up is #PARAMEDIC2! Well designed and executed to answer a challenging question - does epi improve outcomes in #OHCA? Still generating discussion 2 years later https://t.co/Dh9Cp8UliK

May 19, 2020 · 12 likes · 2 shares · 5,449 followers View post →
Mihai Trofenciuc
@MihaiTrofenciuc · X

RT @krychtiukmd: Epinephrine in out of hospital cardiac arrest - higher 30-day survival, BUT no diff in favorable neurologic outcome! now?…

May 13, 2020 · 7 shares · 3,873 followers View post →
Dan
@dsdarbyshire · X

RT @shanfernands: @dwmessenger @TheSGEM Hard to think of too many papers that have on their own changed worldwide EM practice more than the…

Apr 23, 2020 · 1 share · 1,360 followers View post →
Shannon Fernando
@shanfernands · X

@dwmessenger @TheSGEM Hard to think of too many papers that have on their own changed worldwide EM practice more than the REVERT trial: https://t.co/R4GGl6lR5T For most controversial, would also add PARAMEDIC-2, which has challenged dogma on OHCA managmeent: https://t.co/PAiUAkvV7p

Apr 23, 2020 · 3 likes · 1 share · 1,198 followers View post →
tolquen
@tolquen · X

@idrissaberkane non. les essais cliniques contrôlés sont l'unique source de savoir fiable en médecine. c bien ce qui est reproche au Pr Raoult, pas le double aveugle. on peut tout tester avec un groupe contrôle même l'adrénaline vs placebo dans l'arrêt cardiaque https://t.co/JdTUHWnZiL

Apr 18, 2020 · 798 followers View post →
tolquen
@tolquen · X

@JBRPHND @MedicusFR Nuremberg, Helsinki, des conférences de vendeurs de crème contre l'acné quoi... tenez juste une étude clinique menée selon les règles de l'art : 8000 patients adrenaline vs placebo dans l'arrêt cardiaque. comme quoi on peut faire de la bonne médecine https://t.co/JdTUHWnZiL

Apr 17, 2020 · 3 likes · 798 followers View post →
BLOCKCHOC
@BLOCKCHOC1 · X

@ChristopheDigel @Denis_Faust @fluidloading https://t.co/4C3hbGB3mE

Apr 4, 2020 · 1 like · 1,062 followers View post →
SAMFyC
@SAMFyC · X

RT @PontealdiaURG: #RevisiónUrgencias La #adrenalina en PCR extrahospitalaria mejoró la supervivencia al mes pero sin resultado neurológico…

Feb 19, 2020 · 2 shares · 4,719 followers View post →
EM2025
@em_em2025 · X

RT @intensivecare_c: 院外心停止に対して、エピネフリン vs プラセボを比較したPARAMEDIC2はこちら。 https://t.co/0lFlouqrci

Feb 1, 2020 · 5 shares · 228 followers View post →
上白石粗茶
@sochany · X

RT @intensivecare_c: 院外心停止に対して、エピネフリン vs プラセボを比較したPARAMEDIC2はこちら。 https://t.co/0lFlouqrci

Feb 1, 2020 · 5 shares · 389 followers View post →
田中竜馬
@ryoma_tanaka · X

RT @intensivecare_c: 院外心停止に対して、エピネフリン vs プラセボを比較したPARAMEDIC2はこちら。 https://t.co/0lFlouqrci

Feb 1, 2020 · 5 shares · 21,242 followers View post →
TSK
@TSK010 · X

RT @intensivecare_c: 院外心停止に対して、エピネフリン vs プラセボを比較したPARAMEDIC2はこちら。 https://t.co/0lFlouqrci

Jan 31, 2020 · 5 shares · 686 followers View post →
集中治療クラブ
@intensivecare_c · X

院外心停止に対して、エピネフリン vs プラセボを比較したPARAMEDIC2はこちら。 https://t.co/0lFlouqrci

Jan 30, 2020 · 11 likes · 5 shares · 13,507 followers View post →
まなみ｜Care & Save.
@O_Oo333 · X

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest https://t.co/ceVRujCdde

Jan 23, 2020 · 2,676 followers View post →
Miletich-Barkovich
@Marina87251891 · X

RT @FsmAcil: Hands-only CPR is going to be the future of resuscitation, I guess

Aug 10, 2019 · 1 share · 3,463 followers View post →
Andrew Bowman, ACNP, FAEN
@AndrewACNP1 · X

RT @seth_kelly: @amalmattu Perkins et al. "A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest" DOI: 10.1056/NEJMoa1806842.…

Jun 26, 2019 · 2 shares · 1,585 followers View post →
U of Maryland Emergency Med
@UMEmergencyMed · X

RT @seth_kelly: @amalmattu Perkins et al. "A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest" DOI: 10.1056/NEJMoa1806842.…

Jun 26, 2019 · 2 shares · 11,834 followers View post →
Seth Kelly
@seth_kelly · X

@amalmattu Perkins et al. "A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest" DOI: 10.1056/NEJMoa1806842. EPI = early survival, worse neuro; appears best in non-shock rhythms; less effective when given late. #resus2019

Jun 26, 2019 · 3 likes · 2 shares · 2,093 followers View post →
@joe_dunning
@joe_dunning · X

RT @NEJM: Original Article: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest (PARAMEDIC2) https://t.co/r9uHhc4GC0 Edito…

Jun 21, 2019 · 287 shares · 148 followers View post →
Raj Mehta
@raj_mehta · X

@NealSParikhMD @barttels2 @reverendofdoubt @TheSGEM @ohsuneuro @JAMANeuro @NeurologyToday @TheLancetNeuro @NeurologyCP @theABN_Info @kevinmd @AmbuUSA @AANMember As an example, here is (re)analysis of paramedic2 trial, where instead of combining/binning death(6) with score of 5, ordinal analysis was done with 5 ranked worse than 6. https://t.co/AJLAGISDBD

Feb 27, 2019 · 3 likes · 2,137 followers View post →
Shella Jardiniano
@sjardiniano1 · X

RT @MCQALS: Regarding Epinephrine (adrenaline), which of the following statements is CORRECT?: Check your answers at: https://t.co/GYyzy5DW…

Feb 24, 2019 · 1 share · 683 followers View post →
ALSMCQ
@MCQALS · X

Regarding Epinephrine (adrenaline), which of the following statements is CORRECT?: Check your answers at: https://t.co/GYyzy5DWAT https://t.co/3i75iXbBng https://t.co/KlGC91svEm

Feb 24, 2019 · 3 likes · 1 share · 743 followers View post →
Rasha Buhumaid
@RBuhumaid · X

6/10 must know papers from 2018 ... ⁦@SaudiEmergency⁩ #sasem19 A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. - PubMed - NCBI https://t.co/zH4UmttsgS

Feb 5, 2019 · 1,847 followers View post →
Julie G
@tacbarbie44 · X

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. Significantly higher rate of 30-day survival, no improved neurological outcome. #paramedic #OHCA https://t.co/5JvWKssHdh

Jan 28, 2019 · 1 like · 459 followers View post →
Farmacología
@Farmaco_curso · X

Discusión: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest https://t.co/0NRAh3O90B Cartas al Editor: Epinephrine in Out-of-Hospital Cardiac Arrest https://t.co/lNckDWJWwG Antecedentes: https://t.co/nihm6H77nf

Jan 23, 2019 · 39 followers View post →
Critical Care Talk
@NWCriticalCare · X

#CCR19 Trial: Paramedic2 Speaker / Author: Gavin Perkins What was the question: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest https://t.co/C54wRsl2rW https://t.co/9KYHJTtyaZ

Jan 18, 2019 · 793 followers View post →
Andrew Henson
@AndrewHenson74 · X

RT @ICS_updates: PARAMEDIC-2: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest - Gavin Perkins https://t.co/MB2YeORR7g…

Jan 10, 2019 · 7 shares · 200 followers View post →
Sister Starkey RNC, BSc (Hons)
@CritCareKirst · X

RT @ICS_updates: PARAMEDIC-2: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest - Gavin Perkins https://t.co/MB2YeORR7g…

Jan 9, 2019 · 7 shares · 1,225 followers View post →
Donna Clift
@Clifty40 · X

RT @ICS_updates: PARAMEDIC-2: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest - Gavin Perkins https://t.co/MB2YeORR7g…

Jan 9, 2019 · 7 shares · 217 followers View post →
gavin denton
@DentonGavin · X

RT @ICS_updates: PARAMEDIC-2: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest - Gavin Perkins https://t.co/MB2YeORR7g…

Jan 9, 2019 · 7 shares · 1,677 followers View post →
Intensive Care Society
@ICS_updates · X

PARAMEDIC-2: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest - Gavin Perkins https://t.co/MB2YeORR7g https://t.co/GoDthQlfym

Jan 9, 2019 · 11 likes · 7 shares · 40,012 followers View post →
gregor prosen
@gregorprosen · X

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. - PubMed - NCBI https://t.co/1tQi5Oa5bb

Jan 1, 2019 · 2,931 followers View post →
Natalie May
@nmay.bsky.social · Bluesky

Open access! The PARAMEDIC-2 trial: a randomised placebo-controlled trial of adrenaline (epinephrine) in OOH cardiac arrest #FOAMed https://www.nejm.org/doi/full/10.1056/NEJMoa1806842

Jul 18, 2018 View post →