The Adrenaline Paradox

Adrenaline (epinephrine) is a key drug in ANZCOR-aligned ALS for cardiac arrest — but what's really happening? Its alpha-adrenergic effects cause vasoconstriction, boosting coronary and cerebral perfusion to improve ROSC chances. The beta-adrenergic side ramps up heart rate and contractility... which can spike myocardial oxygen demand and contribute to poorer neurological outcomes in survivors.We cover the basics: standard 1 mg dosing, timing in shockable rhythms, and why evidence shows ROSC gains but often no long-term neuro benefit — or even risks. Quick, practical insights for paramedics, nurses, and doctors.