August 29, 2018 – Epinephrine Use

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Anchor lead: Does using epinephrine help when people experience a heart attack outside the hospital? Elizabeth Tracey reports

The hormone epinephrine is often used by paramedics to restart the heart in people who’ve experienced an out of hospital cardiac arrest. Now a new study demonstrates that while more of those folks survive, they are more often neurologically compromised. Gabor Kelen, director of emergency medicine at Johns Hopkins, says the best strategy remains quick transport.

Kelen: The EMS community is a very skilled group of people, and can do an awful lot in the field. You have to balance that against time. There have been quite a few studies on this. The faster you get a patient to definitive care, the more likely a good outcome. So the paramedics should only do what absolutely needs to be done or can be done in transport more or less the same as if there were in a  highly skilled emergency department or trauma reception setting. :30

Kelen says more studies are needed before any change in practice can be advocated, and notes that other studies have shown a clear benefit from bystander initiated CPR, so if you suspect you’re witnessing a heart attack, step in. At Johns Hopkins, I’m Elizabeth Tracey.