Paramedic-2 (Randomised placebo controlled trial of adrenaline for out of hospital cardiac) is a pragmatic cluster randomized controlled trial.

In the trial, 4471 patients in cardiac arrest in the community either received chest compression delivered by a mechanical (Lucas2) device (1652) or manual chest compressions (2819). The device was assigned in a ratio 1:2 ambulances within each of 4 Ambulance Trusts in UK.

A range of mechanical devices to deliver chest compressions within a cardiac arrest have come into healthcare in the last 8 years. This study tested the efficiency of one of these commonly used devices against conventional manual CPR.

This very large study failed to show any benefit of this mechanical device in reducing mortality. Therefore a strong recommendation is that although these devices do no significant harm, a cost benefit of the device cannot be supported.

NIHR summary.