Epinephrine Drip During Arrest

Remi said:
we probably shouldn't even still be giving it - at least not in the massive doses that we do.
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Perhaps one day we will no longer carry 1:10,000 1mg amps. I would like to see prefilled 100mcg/10ml syringes in its place if PARAMEDIC 2 determines 1mg boluses are worthless in cardiac arrest. At least then we could cut a step out of prepping push doses for other uses.
 
SunshineRay said:
What about placing a drip for fast narrow PEA with sudden increases in ETCO2?
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Narrow complex tachycardia PEA usually means an issues that Epi isn't going to fix, I.e massive hypovolemia, PE, septal rupture.
 
How about with a medical arrest that went PEA after 8 defibs for V-fib and with heart tones still present? Maybe it was a septal rupture... ultrasound would have been nice but we work with the tools we have.
 
I don't think Epi going to help you there. What was the Final determination of the cause of his arrest? That would be an indicator.
 
SunshineRay said:
What about placing a drip for fast narrow PEA with sudden increases in ETCO2?
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I'd sure try it. Barring a catastrophic bleed, I really wouldn't hesitate to give epinepherine here. Tamponade, PE...just to get them to the OR/ECMO. Even in the extremely unlikely event of a septal or ventricular blow out (a narrow QRS would be unlikely) you'd have nothing to lose.
 
We dont have epi bristojets right now. Pharmacy has given us 1:1000 epi with a water vial and a 10ml syringe in a premade kit, so we have to draw both up into the syringe and push that during arrests. Since that throws cognitive offloading out the window, Ive been wondering about putting epi into a bag and running it during arrests given Paramedic-2
 
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