Evidence-based On-call

Cardiac arrest

Immediate management

There is no clear benefit from adrenaline ^a

Why?

High dose epinephrine compared with standard dose adrenaline ^a or placebo ^d has no effect on survival, but increases the risk of brain damage ^b

A high cumulative dose of epinephrine increases the risk of brain damage

Patient	Prognostic Factor	Outcome	CER	OR (95% CI)	NNF+ (95% CI)
cardiac arrest ^b	cumulative dose of adrenaline > 5 mg independent	unfavourable neurological outcome at 6 months	16%	1.22 (1.01 to 1.46)	36 (18 to 770)