Methodology: 4/5
Usefulness: 4/5
Vallentin MF, et al. N Engl J Med. 2024 Oct 31. doi: 10.1056/NEJMoa2407616.
Editorial: The Way to a Patient’s Heart – Vascular Access in Cardiac Arrest
Question and Methods: This RCT compared IO vs. IV vascular access in adults with OHCA, using ROSC as a primary outcome.
Findings: No significant difference was found between IO and IV access regarding ROSC, nor any other of their secondary outcomes although the trial was underpowered to detect those.
Limitations: The trial was not blinded, not powered to detect patient-oriented outcomes, and there was a significant number of patients randomized in error.
Interpretation: Both IV and IO methods of access are effective and neither approach is clearly superior with respect to rates of ROSC. It is likely best to choose the most readily available method or the one clinicians are most comfortable with.
JC Supervisor: Dr. Christian Vaillancourt
Authors
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Dr. Seliga is a resident physician in Emergency Medicine at the University of Ottawa. She has special interests in Inner City Health and Addiction Medicine.
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Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.
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Senior Scientist, Clinical Epidemiology Program Ottawa Hospital Research Institute Full Professor, Emergency Medicine University of Ottawa Research Chair in Emergency Cardiac Resuscitation, Emergency Medicine University of Ottawa Associate Medical Director, Regional Paramedic Program for Eastern Ontario Research Interests: Dr. Vaillancourt's current research program focuses on pre-hospital care, specifically improving care and survival for cardiac arrest and trauma victims.
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