Delay to Epinephrine Linked with Worse Outcomes in Children with In-Hospital Cardiac Arrest

Using data from the national Get With the Guidelines–Resuscitation registry from 2000 to 2014, investigators evaluated the effect of time to administration of first epinephrine dose on outcomes in children (age <18 years) with in-hospital cardiac arrest and initial nonshockable rhythms. Patients with trauma and those with cardiac arrest in the delivery room were excluded.

Of 1558 children (median age, 9 months), 64% had return of spontaneous circulation (ROSC), 48% were alive at 24 hours, 31% survived to hospital discharge, and 16% survived with favorable neurological outcome (no or mild cerebral disability). Time to the first epinephrine dose ranged from 0 to 20 minutes (median time, 1 minute). In multivariable analyses adjusting for potent…