North East Ambulance Service NHS Foundation Trust is taking part in a trial involving patients who have suffered a cardiac arrest, called SPIDERMAN.
Information about this research
A cardiac arrest occurs when the heart suddenly stops beating. NHS ambulance services attend approximately 30,000 such incidents annually to provide a treatment called cardiopulmonary resuscitation (CPR). Prompt and effective CPR is essential to prevent damage to vital organs and increases the chance of survival. In addition to CPR other advanced treatments may be given like defibrillation (electrical shocks) and drug therapy.
After resuscitation, defibrillation and drug therapy, some patients hearts start beating again. When this happens many patients need a drug called adrenaline to help maintain their pulse and blood pressure, which is essential to ensure their heart doesn’t stop beating again. This is delivered by the paramedic usually via a cannula inserted into a vein. It can be difficult to deliver this drug accurately, on time and safely in a moving ambulance during the journey to hospital. An alternative way to deliver adrenaline on the way to hospital would be to use a pump called an infusion. This means that the patient would receive a continuous dose of adrenaline via a cannula inserted into a vein driven by the infusion rather than manually by the paramedic. However, it is unknown if this method is practical in an ambulance and there is no evidence it will improve the chances of the patient surviving. Knowing this is important so we can decide if we should use an infusion to deliver drugs or not. The trial is running between June 2026 and July 2027.
What is the purpose of this research?
The aim of this trial is to determine the feasibility of delivering adrenaline after a patient’s heart has restarted after cardiac arrest by infusion rather than manually by the paramedic.
How many people will be involved?
NHS Specialist Paramedics in Critical Care in North East Ambulance Service will recruit 120 patients to the trial - half will receive adrenaline manually and half will receive adrenaline via infusion. This will be decided by chance. This is known as a randomised controlled trial and is the best way of finding out which treatment is most effective.
Do I have to take part?
Most patients will be unconscious after their heart starts beating again. Because of this, and because the patient still needs emergency care, it will not be possible to ask the patients permission about taking part in this trial.
An NHS Research Ethics Committee has given the ambulance research team permission to enrol patients without their consent.
In the event that you suffer a cardiac arrest and you do not wish to take part in this trial, please contact the Chief Investigator for the trial Karl Charlton on karl.
Who has reviewed the project?
This study has been approved by the NHS Health Research Authority, has been reviewed by Yorkshire & The Humber - Leeds West Research Ethics Committee which gave a favourable opinion (reference 26/YH/0075) and has been reviewed by the Confidentiality Advisory Group (CAG). Following CAG review the study is supported by Section 251 support from the Health Research Authority (reference 26/CAG/0052).
Research Ethics Committee approval and the Mental Capacity Act provides the legal basis for enrolling participants to this trial, and is applicable up to the point where a surviving participant provides written informed consent (or declines participation), or if consultee consent is obtained. Section 251 support is required where a patient has died and where consent, or consultee advice has not been obtained. In this situation, data will only be held for up to 1-month so we can determine the final outcome, after which all data will be anonymised and no confidential patient information retained.