Jeremy H. Howick writes in the book "The Philosophy of Evidence-based Medicine":

Perhaps the most striking [paradox of EBM] is that many of the treatments in whose effectiveness we have the most confidence – that we consider to be most strongly supported by evidence have never been supported by randomized trials of any description. These treatments include automatic external defibrillation to start a stopped heart, tracheostomy to open a blocked air passage, and the Heimlich maneuver to dislodge airway obstructions.

Is it true that there are no controlled randomized trials that support the usage of automatic external defibrillation to start a stopped heart?

  • 2
    AEDs apply an electric shock to return an irregularly beating heart to a normal rhythm. It doesn't start a stopped heart - you'd just be applying electricity to a corpse, á la Frankenstein. – user1666620 Apr 8 '16 at 13:11
  • I think there might just be an ethics committee issue with a controlled randomised trial on emergency treatments. Would you volunteer for such a trial? Pretty sure I wouldn't! – Dikran Marsupial Apr 9 '16 at 14:01
  • This makes about as much sense as a test to see if brakes can make a car go. – Loren Pechtel Apr 9 '16 at 17:59

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