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POHCA Resuscitation: Evaluation of IM Epinephrine

POHCA Resuscitation: Evaluation of IM Epinephrine

Recruiting
1-17 years
All
Phase 2/3

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Overview

This is a pragmatic, two-arm, open-label, prospective stepped-wedge cluster quasi randomized control trial (SW-CRCT) looking to evaluate early intramuscular (IM) epinephrine in the management of pediatric out-of-hospital cardiac arrest (POHCA).

Description

IM epinephrine may provide a more efficient means of administering the initial epinephrine dose (versus IV/IO administration) to a child experiencing pediatric out of hospital cardiac arrest (POHCA) with no greater risk of harm. In so doing, this may improve the short- and long-term outcomes of these patients. There is an abundance of literature detailing the risk/benefit profile of IM epinephrine use in anaphylaxis; however, there is no human data on this topic as it relates to cardiac arrest. Important knowledge gaps include whether the use of IM epinephrine via autoinjector and/or pre-filled syringe leads to faster administration of the initial doses of epinephrine without delaying time to definitive epinephrine (via IV/IO) and the impact on time to initial and sustained return of spontaneous circulation (ROSC). This trial will be the first to examine the role of IM epinephrine via autoinjector/pre-filled syringe in POHCA.

Eligibility

Inclusion Criteria:

  • Children aged 1 day to and including 17 years experiencing an out-of-hospital cardiac arrest (OHCA)
  • Must be receiving at least 1 minute of CPR by trained first responders (police, fire, or paramedic services)

Exclusion Criteria:

  • Children who experience OHCA due to an obvious traumatic event.

Study details
    Pediatric Out-of-Hospital Cardiac Arrest

NCT05166343

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

16 October 2025

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