| Pre-hospital cardiopulmonary resuscitation for patients with out of hospital cardiac arrest commonly includes administration of adrenaline (epinephrine) by emergency medical services. Despite extensive research on its effectiveness, there is no definite evidence to support its routine use. Whether pre-hospital use of adrenaline improves long term prognosis remains uncertain, although it unequivocally increases return of spontaneous circulation.1 2 Recent randomised controlled trials showed slightly favourable (but non-significant) effects of pre-hospital adrenaline in improving long term survival, whereas observational studies have not indicated any significant favourable effects and some large scale registry based studies have even shown detrimental long term effects.
Objectives: To evaluate the effectiveness of pre-hospital adrenaline (epinephrine) administered by emergency medical services to patients with out of hospital cardiac arrest.
Conclusions:Pre-hospital administration of adrenaline by emergency medical services improves the long term outcome in patients with out of hospital cardiac arrest, although the absolute increase of neurologically intact survival was minimal. ...more |
