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Symptomatic Bradycardia: The Epinephrine Era Ends

Handtevy

It’s official: the 2025 ILCOR Pediatric Life Support guidelines have removed the recommendation to administer cardiac arrest dose epinephrine for symptomatic bradycardia in children. Hallelujah For years, the use of epinephrine in bradycardic pediatric patients receiving CPR has been embedded in resuscitation algorithms. Resuscitation.

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Emergency Evidence Updates – May 2025

The Bottom Line

Skip to content Twitter Google+ Facebook Reddit RSS The Bottom Line A compendium of critical appraisals in Intensive Care Medicine research and related specialties Home About Us Summaries Intensive Care Medicine Emergency Medicine Peri-operative Medicine Blog News EBM Editorial Submit a review Wessex ICS You are here: Home Blog Emergency Evidence Updates (..)

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IV versus IO for cardiac arrest (PARAMEDIC3 and IVIO)

First 10 EM

In the most recent BroomeDocs podcast, we talk about an attempt to use the IM route to give cardiac arrest victims epinephrine faster. The podcast and Research Roundups blog post might actually come out next week.)

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A Simplified Protocol for Intralipid Administration in the Emergency Dept.

ACEP Now

Smaller doses of epinephrine are recommended (start at <1mcg/kg). Checklist for Treatment of Local Anesthetic Systemic Toxicity: ASRA Pain Medicina November 1.2020 Available at: [link] publications/asra-updates/blog-landing/guidelines/2020/11/01 Ashacklist for-treatment-of-loc-anesthetic-systemic-toxicity Accessed 30, 2025.

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The Guidelines Graveyard: What gets chosen, what gets buried?

Handtevy

Yet at the same time, despite a large-scale Holmberg study involving over 6,000 patients suggesting potential harm, epinephrine remained part of the pediatric symptomatic bradycardia protocol. That study went to the graveyard and will likely never be repeated.

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repost this one as QRS distortion

Dr. Smith's ECG Blog

Translate Follow us on X (Twitter) Follow @smithECGBlog Follow @PendellM Follow @ekgpress Follow @AslangerE Follow @ecgcases Follow @PMcardioBot Total Pageviews Use this Blog as a Textbook I highly recommend using this blog as an atlas or textbook. Five Primary Patterns of Ischemic ST depression, without ST elevation.

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A patient with chest pain. (post on Normal ECG)

Dr. Smith's ECG Blog

Translate Follow us on X (Twitter) Follow @smithECGBlog Follow @PendellM Follow @ekgpress Follow @AslangerE Follow @ecgcases Follow @PMcardioBot Total Pageviews Use this Blog as a Textbook I highly recommend using this blog as an atlas or textbook. Five Primary Patterns of Ischemic ST depression, without ST elevation.

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