Give that EPI early in non-shockable arrest in hospital cardiac arrest

Rohan Khera, Paul S. Chan published in circulation about timing of epinephrine in non-shockable cardiac arrest (in hospital) across 548 hospitals who participate in “get on with the guidelines” database.

What they did

They looked at 103,932 adult patients with non-shockable cardiac arrests from 2001 to 2014.

13,213 (12.7%) patients had delays to epinephrine (more than 5 minutes).

There was an inverse correlation between a hospital’s rate of delayed epinephrine administration and its risk-standardized rate of survival to discharge (ρ= -0.22, P<0.0001).

 

Other thoughts

Other than delayed response to the delivery of the drug(Lack of training!, availability within reach), most likely cause in my mind would lack of IV access. All hospitalized patient should have one working IV access, ideally.

Bottomline

Give epinephrine as early as possible in case of non-shockable in hospital cardiac arrest.

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