EMS LHP – E76 – One and Done Epinephrine

Y’all know I have thoughts on epinephrine in cardiac arrest. Perhaps you might have heard me say epinephrine “saves the heart at the expense of the brain.” I’ve also said I don’t have an issue with any epinephrine in arrest, just how we give it currently, and have wondered if less epi might do the trick. We reviewed the One and Done paper recently published from North Carolina that looks at this question. Citations: 1.      Ashburn NP, Beaver BP, Snavely AC, Nazir N, Winslow JT, Nelson RD, Mahler SA, Stopyra JP: One and Done Epinephrine in Out-of-Hospital Cardiac Arrest? Outcomes in a Multiagency United States Study. Prehospital Emergency Care. 2022;September 26;27(6):751–7.2.      Fernando SM, Mathew R, Sadeghirad B, Rochwerg B, Hibbert B, Munshi L, Fan E, Brodie D, Di Santo P, Tran A, et al.: Epinephrine in Out-of-Hospital Cardiac Arrest. Chest. 2023;August;164(2):381–93.