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In the prehospital setting, resources are minimal, and paramedics often transport patients who remain in cardiac arrest to the hospital. The current Advanced Cardiac Life Support (ACLS) guidelines recommend 1 mg of 1:10,000 epinephrine for cardiac arrest followed by repeated doses every 3 to 5 minutes for patients who have no return of spontaneous circulation. To determine whether paramedics follow these guidelines, researchers retrospectively reviewed a database of all adult prehospital cardiac arrest patients during a 20-month period from 35 private, fire, and hospital-based ambulance services in four states.
Of 11,000 advanced–life-support calls, 70 cardiac arrest patients met the entry criteria of having received at least one dose of epi…