Epinephrine in OHCA!

We discussed 2 studies in our class specific session on impact of EPi on out of hospital cardiac arrest. J Am Coll Cardiol published another study  this month and challenged again use of Epi in OHCA. 1,556 patients from 2000 to 2012, using EPi with different doses, and the conclusion is  pre-hospital use of epinephrine was consistently associated with a lower chance of survival.

(French) JACC: Is Epinephrine During Cardiac Arrest Associated With Worse Outcomes in Resuscitated Patients?

(Japan) JAMA: Prehospital epinephrine use and survival among patients with out-of-hospital cardiac arrest. 

(Australian) Resuscitation:  Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomised double-blind placebo-controlled trial