'Resuscitation drug adrenaline questioned in cardiac arrest'
There are concerns that adrenaline, used for more than 50 years as a key part of resuscitation, can do more harm than good. But the study will mean some patients across England and Wales being given a placebo without their consent. Experts say the research throws up a number of ethical challenges, BBC News reports. 'Critical time' More than 50,000 people suffer cardiac arrests outside of hospitals each year in the UK. During arrests their hearts stop beating completely and most people do not survive. Currently only 8% leave hospital alive. Paramedics follow a protocol for anyone found without a heartbeat - this involves chest compressions, shocking the heart with a defibrillator and giving a shot of adrenaline if shocks don't work. But over the past decade some scientists have suggested adrenaline could do more harm than good. There is some evidence it may damage the brain by reducing blood supply to the head and could diminish the chances of survival. The Warwick University study will involve 8,000 people in London, Wales, the West Midlands, and the South Coast and north-east of England who have a cardiac arrest. Half the patients will receive the dummy medicine and half will get adrenaline - but as they will be unconscious there will be no consent gathered as the drug is administered. Paramedics will also not attempt to get consent from relatives or passers-by as the researchers emphasise that time is critical during resuscitation. But they say local residents will be given information on the trial and details about how to opt out. Depending on local arrangements, this could involve ringing their ambulance service and being put on a computerised register - but details are yet to be finalised. 'No active consent' After the arrest, relatives will not be told whether their family members received the drug or the dummy version. Dr Daniel Sokol, a medical ethicist and barrister who is not involved in the study, said: "A challenging aspect of this research is the lack of informed consent regarding a life-and-death intervention. "The question then is: 'Is this research sufficiently potentially beneficial that we can forego proper consent?'"
