Quick epinephrine administration induces favorable neurological outcomes in out-of-hospital cardiac arrest patients

Objective

This research is to study if quick administration of adrenaline on OHCA prior to hospitalization has an effect on improving CPC1-2 at one month.

Methodology

A total 13,326 cases were extracted from 2011 to 2014 Utstein data for this retrospective cohort study, also, EMT reached the patients within 16 min after 119 called and adrenaline was then administered within 22 min of after contact.

Patients divided into two groups

Patients were contacted within 8 min of the 119 call (n = 6956), and were contacted between 8 and 16 min after the call (n = 6370). Further divided into groups in which the adrenaline was administered within/without 10 min after contact. Primary outcome was the rate of a good prognosis for cerebral performance (CPC1-2) at 1 month and secondary outcome was the return of spontaneous circulation (ROSC) rate.

Results

The odds ratio of the CPC1-2 at 1 month by the EMS reached within 8 min after 119 call and then adrenaline administered within 10 min was 2.12 (1.54–2.92).Those reached between 8 and 16 min was 2.66 (1.97–3.59). However, the ROSC rate was 2.00 (1.79–2.25) for those reached within 8 min and also 2.00 (1.79–2.25) for those reached between 8 min and 16 min.

Considerations

In cases of OHCA, it appears that the CPC1-2 rate after 1 month can be improved even in cases where the victim is reached > 8 min after the 119 call, as long as the victim is reached within 16 min and emergency responders administer the adrenaline as quickly as possible.