Immediately Shock Patients with Shockable Rhythms in Cardiac Arrest

For patients with shockable rhythms (i.e., ventricular fibrillation or pulseless ventricular tachycardia), guidelines recommend epinephrine only after several refractory defibrillation attempts. However, epinephrine frequently is administered inappropriately prior to the first or second defibrillation attempt. To determine the effect of epinephrine when it is administered for shockable rhythms prior to initial defibrillation, researchers retrospectively identified 35,000 patients — hospitalized at 500 U.S. hospitals between 2000 and 2018 — with in-hospital arrest due to ventricular fibrillation or pulseless ventricular tachycardia. Epinephrine was given before defibrillation in 28% of patients. About 9000 patients who received epinephrine b…