On this episode Nicholas gives us a rundown in “Best Evidence Topic” aka BET format on how epinephrine effects neurological outcomes after ROSC. ROSC is an acronym that stands for Return Of Spontaneous Circulation, which is actually a bit of a misnomer as it refers to when we get a pulse back after doing CPR. There is emerging evidence about epinephrine’s effect on someone’s neurological impairment after receiving substantial doses during a resuscitation. We take a look at some of those new articles and compare the evidence.


  1. Jacobs IG, Finn JC, Jelinek GA, Oxer HF, Thompson PL. Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomised double-blind placebo-controlled trial. Resuscitation. 2011;82(9):1138-1143. doi:10.1016/j.resuscitation.2011.06.029.
  2. Tomio J, Nakahara S, Takahashi H, et al. Effectiveness of Prehospital Epinephrine Administration in Improving Long-term Outcomes of Witnessed Out-of-hospital Cardiac Arrest Patients with Initial Non-shockable Rhythms. Prehosp Emerg Care. 2017;0(0):1-10. doi:10.1080/10903127.2016.1274347.
  3. Hubble MW, Tyson C. Impact of Early Vasopressor Administration on Neurological Outcomes after Prolonged Out-of-Hospital Cardiac Arrest. Prehospital Disaster Med. January 2017:1-8. doi:10.1017/S1049023X17000115.
  4. Ristagno G, Tang W, Sun S, Weil MH. Cerebral cortical microvascular flow during and following cardiopulmonary resuscitation after short duration of cardiac arrest. Resuscitation. 2008;77(2):229-234. doi:10.1016/j.resuscitation.2007.12.013.
  5. Olasveengen TM, Wik L, Sunde K, Steen PA. Outcome when adrenaline (epinephrine) was actually given vs. not given – post hoc analysis of a randomized clinical trial. Resuscitation. 2012;83(3):327-332. doi:10.1016/j.resuscitation.2011.11.011.

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