A recent article by a group of emergency physicians, a cardiologist and a firefighter from Salt Lake City. They asked themselves an important question. Whether epinephrine can be administered intramuscularly in patients in cardiac arrest with difficulties in obtaining intravascular or intravenous access. The study was launched in 2010, during which time a group of 1,405 non-traumatic adult cardiac arrests were collected.
INTERVENTION: 5mg epinephrine intramuscularly before insertion vs. standard procedure
Results:
420 people received 5mg of adrenaline im. vs. 985 people standard procedure
Time to adrenaline 4.3min vs 7.8min
Survival to hospital arrival 37.1% vs. 31.6%
In-hospital survival 11.0% vs. 7%
Good neurological status at discharge 9.8% vs 6.2%
Considering the cost of an ampoule of epinephrine, the possibility of acquiring 5mg of epinephrine while arriving at the incident and administering the epinephrine as while the other person on the team is assessing the rhythm…..think that a very interesting study and a good chance to implement such a procedure in daily practice.
Link: https://www.resuscitationjournal.com/article/S0300-9572(24)00159-X/abstract