UMEM Educational Pearls

Title: Single dose epinephrine in OHCA- survival to discharge

Category: EMS

Keywords: single dose, epinephrine, cardiac arrest, survival (PubMed Search)

Posted: 10/25/2025 by Robert Flint, MD (Updated: 10/27/2025)
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The authors conducted a pre- and post-implementation study after five North Carolina county EMS agencies switched to single dose epinephrine during out of hospital cardiac arrest treatment from the traditional multidose (every 3-5 minutes) protocol.  They looked at 1 year before and 1 year after implementation. They found no difference in survival to discharge from the hospital in the two groups but there was less return to spontaneous circulation in the single dose group.

References

Ashburn, N. P., Beaver, B. P., Snavely, A. C., Nazir, N., Winslow, J. T., Nelson, R. D., … Stopyra, J. P. (2022). One and Done Epinephrine in Out-of-Hospital Cardiac Arrest? Outcomes in a Multiagency United States Study. Prehospital Emergency Care, 27(6), 751–757. https://doi.org/10.1080/10903127.2022.2120135