This week’s podcast from BASICS Scotland is with Tom Quinn, who explains the findings of the Paramedic 2 trial.
Paramedic 2 has been described as a landmark study, the results of which have challenged conventional methods used to prioritise restarting the heart during an out of hospital cardiac arrest.
Key points from this podcast:
- Basic support of high quality chest compressions and early defibrillation yield the most in case of good patient outcomes
- The medicines we have do not have strong evidence to benefit whether for adrenaline, amiodarone or lignocaine in terms of sustained positives effects on survival with a good neurological outcome, although adrenaline has now been proven to increase your likelihood of ROSC
- Neuro protective brain should be the focus of ongoing research
Resources related to this podcast:
PARAMEDIC-2 trial main paper https://www.nejm.org/doi/pdf/10.1056/NEJMoa1806842
Repeated adrenaline doses and survival https://www.resuscitationjournal.com/article/S0300-9572(19)30007-3/fulltext
ILCOR systematic review on vasopressors in cardiac arrest https://www.resuscitationjournal.com/article/S0300-9572(19)30122-4/fulltext
2019 Consensus on Science and Treatment Recommendations (ILCOR) https://www.resuscitationjournal.com/action/showPdf?pii=S0300-9572%2819%2930665-3
Video of a talk I gave on the PARAMEDIC-2 trial https://www.youtube.com/watch?v=6aRd1iB0Hnw
Presentation at the European Society of Cardiology annual Congress, Paris, 2019. https://esc365.escardio.org/Congress/ESC-CONGRESS-2019/New-insights-into-cardiopulmonary-resuscitation/187252-time-to-abandon-adrenaline-in-out-of-hospital-cardiac-arrest
Tom is a cardiac nurse with 40 years’ experience (he started training as an orthopaedic nurse in 1979).
His NHS career has taken him from the bedside – general medicine and cardiac care units at both secondary and tertiary centres including Bart’s and the National Heart Hospital in London, and in York – to central Government where he was section head of the Department of Health policy team responsible for the National Service Framework for Coronary Heart Disease. Along the way he played a significant role in establishing the Defibrillators in Public Places Initiative and later was involved in the development of England’s national programme to provide primary angioplasty (attending and speaking at the initial meeting with the Prime Minister’s Delivery Unit). He subsequently worked strategically at regional level on cardiovascular issues, including 4 years in an ambulance service as a consultant cardiac nurse/regional head of cardiovascular, stroke and research. During this time he became a visiting professor at Coventry University, subsequently moving to the University of Surrey in 2009 as a full professor.
While at Surrey he was Associate Dean for Health & Medical Strategy, leading development of a 10-year strategy for the institution with NHS partners.
On moving to the Joint Faculty at Kingston & St George’s, University of London as Professor of Nursing, Tom took up a leadership role as Associate Dean for Research & Director of the Centre for Health & Social Care Research. On completing this term he became Professor of Cardiovascular Nursing, leading a new Emergency, Cardiovascular & Critical Care Research Group and is now also a BASICS Scotland trustee.