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Tag: Epinephrine

IV or IO Epi in OHCA?

Background: Epinephrine remains a staple in cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA).  However, the optimal dose, timing, and route of administration are still unknown.  Standard dosing of epinephrine is 1mg every 3 to 5 minutes via the intravenous …

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Resuscitation

Critical Care Fundamentals: Management of Shock Part 2A

Shock is defined as circulatory failure leading to decreased organ perfusion.  In a shock state there is an inadequate delivery of oxygenated blood to tissues that results in end-organ dysfunction.  Effective resuscitation includes rapid identification and correction of inadequate circulation. …

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Resuscitation

Rebellion in EM 2019: Pro/Con Debate – Epinephrine in Out of Hospital Cardiac Arrest (OHCA)

Background: Epinephrine (adrenaline) has been used in advanced life support in cardiac arrest since the early 1960s. Despite the routine recommendation for its use, evidence to support administration is less than ideal.  Although it is clear from multiple observational studies …

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Resuscitation

Dosing and Timing of Epinephrine in OHCA

Background: Epinephrine (adrenaline) remains a central part of management of OHCA in ACLS guidelines. Recent studies (i.e. PARAMEDIC-2) have raised concerns about the efficacy and possible deleterious effects of epinephrine on both overall survival and long-term neurological outcomes. Other observational trials have …

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Resuscitation

Why You Should More Than Consider a Vasopressin, Steroid, and Epinephrine (VSE) Cocktail

The newly published 2015 AHA guidelines recommend that: “In IHCA, the combination of Vasopressin, Epinephrine, and Methylprednisolone and post-arrest Hydrocortisone as described by Mentzelopoulos et al. maybe considered; however, further studies are needed before recommending the routine use of this strategy …

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Resuscitation

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