This application is the response of the University of Washington and Emergency Medical Services (EMS) of Seattle and King County, WA to the RFA HL-04-001 entitled """"""""Clinical Research Consortium to Improve Resuscitation Outcomes."""""""" The EMS of Seattle and King County have a programmatic focus on cardiac arrest and life-threatening trauma and continue to make important contributions to each link in the American Heart Association's """"""""chain of survival,"""""""" as well as important advances in trauma management. An experienced group of internationally renown investigators, along with the infrastructure and resources provided by the University with broad community support, are committed to advancing resuscitation science through the training of young investigators in the field of prehospital emergency care and the conduct of clinical trials. This application sets forth 2 research proposals pertaining to management of out-of-hospital cardiac arrest, and life-threatening trauma that exemplify the insights and expertise of the assembled team of researchers and the quality of the local prehospital care system. The cardiac arrest proposal is a prospective, randomized, double-blind comparison of amiodarone, lidocaine and placebo in out-of-hospital ventricular fibrillation that will assess the impact of such treatment on neurologically functional survival. The trauma protocol is a similarly designed comparison of 7.5% hypertonic saline in dextran, 3% saline, and conventional fluid resuscitation on mortality and neurologic function after blunt traumatic injury associated with hypovolemic shock. Each proposal will enroll between 400-500 patients over a two year period, and will have enhanced statistical power to establish their important endpoints through participation of a Consortium of clinical research centers. Finally, a Clinical Research Skills Development Core is proposed, founded on the rich research and teaching environment of the University and prehospital care system to foster and direct the training of young investigators from a variety of disciplines in resuscitation research.
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