Core EM

JANUARY 25, 2024

Consider these medications if there are signs of end-organ dysfunction, there is a considerable delta in baseline BP, systolic is less than 90 and/or MAP is less than 65 Norepinephrine is a good pressor for a lot of the situations that we encounter in the emergency department, such as septic shock, undifferentiated shock and hypovolemic shock.

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Epinephrine Critical Care ED Emergency Department 246

EM Board Bombs

MAY 9, 2025

-Case- A 31-year-old woman rushes into the ED with her lips swelling and a rapidly spreading rash. She was stung by a bee while jogging, and within minutes developed hives, throat tightness, and shortness of breath. On arrival, her vitals are notable for HR of 118 bpm, a BP 82/50 mmHg, and she’s wheezing audibly.

Epinephrine 52

Epinephrine ED 52

EMCrit Project

APRIL 26, 2023

Is there an easier way to mix up push-dose epinephrine that is still as safe? EMCrit Project by Scott Weingart, MD FCCM.

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Epinephrine 105

REBEL EM

DECEMBER 5, 2023

How Long Should We Monitor After Giving IM Epinephrine for Anaphylaxis? Bottom Line Up Top: After prompt recognition and appropriate treatment with IM epinephrine, the risk of biphasic reactions are exceedingly low. At the time of discharge, appropriate patient education and prescriptions for IM epinephrine are essential.

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Epinephrine Allergic Reaction Emergency Department Emergency Management 78

ACEP Now

JUNE 29, 2025

Epinephrine (“epi”). Epinephrine has more balanced a 1 and b Because of this, it will give you both peripheral vasoconstriction from the a 1 and an increase in heart rate (chronotropy) and contractility (inotropy) from the b 1. 3 Typical dosing of epinephrine is 10-20 micrograms every three to five minutes. Ann Emerg Med.

Emergency Department 52

Emergency Department E-9-1-1 Epinephrine Critical Care 52

REBEL EM

JUNE 14, 2023

to 0.5mg (1mg/mL) IV Bolus: 5 to 20mcg (10mcg/mL) IV Infusion: 1 to 20mcg/min If Poor Response to Conventional Therapy Consider Epinephrine 100mcg IV bolus Norepinephrine infusion 0.1mcg/kg/min Vasopressin 0.01

Allergic Reaction 145

Allergic Reaction Epinephrine OR EMS 145

Pediatric EM Morsels

SEPTEMBER 22, 2023

Both norepinephrine and epinephrine can be used. Epinephrine is key if there is significant bradycardia. Crystalloid may help, but neurogenic shock may not respond to fluid administration. Alpha 1 agonists are necessary to maintain appropriate blood pressure.

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E-9-1-1 Epinephrine ALS ED 307

The Skeptics' Guide to EM

JANUARY 13, 2024

We have looked at OHCA more than a dozen times on the SGEM.

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Defibrillator CPR First Responder Epinephrine 272

ACEP Now

JANUARY 5, 2025

6 Apply direct pressure to the bleeding site with gauze soaked in TXA and epinephrine as a first-line intervention. 7 Epinephrine acts as a local vasoconstrictor, aiding hemostasis, and TXA helps to stabilize clot formation on the exposed tissue and delay hemorrhage progression.

Operating Room 98

Operating Room Epinephrine ALS ED 98

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

You and your partner initiate high-quality CPR, place a supraglottic airway, establish intra-osseous (IO) access and administer epinephrine. There is drug paraphernalia scattered around the room. Your partner asks if you want to administer naloxone as well.

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Naloxone NARCAN Overdose CPR 259

EMDocs

APRIL 25, 2025

Navy veteran, he specializes in pediatric trauma care Takehome Points Differentiate Between Traumatic and Medical Cardiac Arrest: The approach to traumatic cardiac arrest is distinct from medical arrest, with hemorrhage control and volume resuscitation taking precedence over standard CPR and epinephrine administration.

EMS 96

EMS Emergency Medical Services Epinephrine CPR 96

The Skeptics' Guide to EM

DECEMBER 7, 2018

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. An oral airway is placed, peripheral intravenous (IV) line started successfully and the paramedic asks her partner if you want to administer IV epinephrine? He is unsuccessfully shocked.

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Epinephrine Advanced Life Support Life Support Defibrillator 130

JEMS

JUNE 6, 2025

Scenario One A paramedic forgets to restock epinephrine 1:1,000 in the medical bag, and the next crew responds to an anaphylaxis call without it. This outdated model has been replaced in high-risk industries like aviation, nuclear power and healthcare by the “Just Culture” model. What happens?

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EMS Mobile Integrated Health EMT EMT 116

University of Maryland Department of Emergency Med

OCTOBER 11, 2023

1,2 Epinephrine autoinjector. Background: It is estimated that nearly 6% of U.S. adults and children report having a food allergy.1,2 Click to view the rest

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Epinephrine 63

EMDocs

JANUARY 4, 2025

1: PARAMEDIC-3 and IVIO RCTs IO vs IV Epinephrine for OHCA Spoon Feed Two large studies randomizing patients with out-of-hospital-cardiac arrest (OHCA) to either an intraosseous (IO) or intravenous (IV) first approach for access had no difference in 30-day survival or neurologically intact survival.

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Epinephrine Paramedic OR 97

Emergency Medicine Cases

MAY 24, 2022

In this first part of our 2-part series on Cardiac Arrest Controversies Rob Simard, Bourke Tillman, Sara Gray and Scott Weingart discuss with Anton how best to ensure high quality chest compressions, the pros and cons of mechanical CPR, the literature on dual sequential defibrillation and optimizing pad placement, epinephrine vs vasopressin, amiodarone (..)

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Defibrillator Epinephrine CPR EMS 130

Emergency Medicine Cases

JANUARY 14, 2020

The post EM Quick Hits 12 AFib Early vs Delayed Cardioversion, Snake Bites, Ovarian Torsion Myths, Crystal Meth, Aortic Dissection, Severe Asthma Meds appeared first on Emergency Medicine Cases.

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Epinephrine EMS Emergency Management Emergency Manager 130

The Skeptics' Guide to EM

DECEMBER 25, 2021

Intraosseous access is quickly obtained, and a dose of epinephrine is provided. Bystander CPR is being performed. The monitor is hooked up. The paramedics performed high-quality CPR and follow their ACLS protocol. CPR is continued while a supraglottic airway is placed successfully.

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Epinephrine CPR ALS Emergency Department 130

The Skeptics' Guide to EM

MAY 8, 2021

SGEM#50 looked at a RCT published in JAMA 2013 looking to see if a vasopressin, steroids, and epinephrine (VSE) protocol for IHCAs could improve survival with favorable neurologic outcome compared to epinephrine alone. I have not seen a validation study published.

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Epinephrine CPR EMS 130

Emergency Medicine Education

SEPTEMBER 2, 2024

Resuscitation recently published an article that assessed the association between intramuscular (IM) epinephrine and survival outcomes, including survival to hospital discharge, survival to hospital admission, and functional survival. Link to article

Epinephrine 40

Epinephrine 40

REBEL EM

JUNE 8, 2023

1-4 The PDPs, phenylephrine and epinephrine, result in vasoconstriction and increased cardiac contractility. They can be associated with side effects such as reflex bradycardia, decreased stroke volume in phenylephrine, tachycardia and hypertension associated with epinephrine.

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Epinephrine Emergency Department ALS Critical Care 98

Emergency Medicine Cases

JULY 3, 2018

The post BCE 73 Esmolol in Refractory Ventricular Fibrillation appeared first on Emergency Medicine Cases.

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Defibrillator Epinephrine EMS 130

Emergency Medicine Education

APRIL 11, 2022

Intensive Care Medicine recently published an article with focus on “Epinephrine versus norepinephrine in cardiac arrest patients with post-resuscitation shock” This study was in Paris metropolitan region. The choice of vasopressor is always a topic of controversy regarding post cardiac arrest patients.

Epinephrine 40

Epinephrine 40

The Skeptics' Guide to EM

OCTOBER 31, 2020

Buffered lidocaine 1%, epinephrine 1:100,000 with sodium bicarbonate (hydrogencarbonate) in a 3:1 ratio is less painful than a 9:1 ratio: A double-blind, randomized, placebo-controlled, crossover trial. Epinephrine in Local Anesthetics: This will not make the tip of things fall off (nose, fingers, toes, etc). Reference: Vent et al.

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Epinephrine Emergency Department EMS ALS 130

The Skeptics' Guide to EM

OCTOBER 22, 2022

This includes epinephrine for OHCA, target temperature management, mechanical CPR, supraglottic airways, steroids, hands on defibrillation and many more topics. Background: We have covered Out of Hospital Cardiac Arrests (OHCAs) many, many times on the SGEM.

CPR 130

CPR Defibrillator Epinephrine Firefighter 130

International Journal of Paramedicine

APRIL 16, 2025

Epinephrine was administered to 163 (13.4%) patients. These patients were followed up to 12 hours after hospital admission to determine which vasopressors they received after hospital admission. RESULTS: A total of 1212 patients were enrolled in this study.

Ambulance 52

Ambulance Epinephrine EMS 52

Pediatric EM Morsels

JULY 19, 2024

Soak the gauze with epinephrine (1:10,000) or TXA (our THIRD route of administration) Apply pressure laterally to the tonsillar fossa with the gauze covered Magill forceps. . < 25 kg = 250 mg up to 3x > 25 kg = 500 mg up to 3x Direct Pressure Always the best way to stop bleeding. Don’t await for fancy meds to arrive from pharmacy.

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E-9-1-1 Epinephrine Emergency Department OR 293

Emergency Medicine Cases

OCTOBER 22, 2019

We discuss that the palpation technique is poor at determining whether or not a patient has a pulse, that the POCUS pulse is more accurate and as rapid compared to the palpation technique at determining whether or not a patient has a pulse, the difference between true PEA arrest, PseudoPEA and PREM, why epinephrine may be harmful in PEA, Weingart's (..)

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Epinephrine EMS OR 130

EMDocs

MARCH 9, 2024

1: Epinephrine or Airway First in OHCA? Spoon Feed In adults presenting to EMS after OHCA, those receiving epinephrine prior to advanced airway management (AAM = supraglottic airway, SGA, or endotracheal tube) experienced better outcomes and prehospital ROSC than those receiving AAM before epinephrine. JAMA Netw Open.

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Epinephrine EMS OR 97

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Epinephrine is provided and you quickly place an advanced airway. A second dose of epinephrine is given, and you start to think about reversible causes and your next steps for in-hospital cardiac arrests (IHCA). Cardiopulmonary resuscitation (CPR) is in progress. The monitor shows a non-shockable rhythm.

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Epinephrine Critical Care Life Support Emergency Department 100

EMergucate

JUNE 27, 2012

Naloxone Epinephrine Atropine Lignocaine yes you can !

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Naloxone Epinephrine 100

EMDocs

JANUARY 8, 2024

Vasopressor medications during cardiac arrest We recommend that epinephrine be administered for patients in cardiac arrest. It is reasonable to administer epinephrine 1 mg every 3 to 5 minutes for cardiac arrest. High-dose epinephrine is not recommended for routine use in cardiac arrest. COR 1, LOE B-R. COR 2a, LOE B-R.

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Epinephrine Defibrillator Coronary CPR 97

Dr. Smith's ECG Blog

JULY 25, 2024

After 1 mg of epinephrine they achieved ROSC. Total prehospital meds were epinephrine 1 mg x 3, amiodarone 300 mg and 100 mL of 8.4% EMS arrived and found him in Ventricular Fibrillation (VF). He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. sodium bicarbonate.

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Defibrillator Coronary ACS Epinephrine 131

ESO

DECEMBER 19, 2024

Read the 2024 ESO EMS Index Read the 2024 ESO Fire Service Index Post-Resuscitation Epinephrine Vs. Norepinephrine in Cardiac Arrest Released in May 2024 Epinephrine and norepinephrine are both commonly used as prehospital vasopressors in the United States.

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Epinephrine First Responder Firefighter Public Safety 103

ACEP Now

JULY 3, 2025

2,3 Vasopressors, ideally norepinephrine or epinephrine, are the next step if fluid resuscitation and antidotes are not successful. 9 Vasopressor of choice should include norepinephrine or epinephrine. One to two liters of crystalloid is a reasonable starting amount.

E-9-1-1 52

E-9-1-1 Overdose Epinephrine Naloxone 52

EMDocs

APRIL 3, 2025

Well, you have two to reach for here, Epinephrine or Dopamine. Both epinephrine and dopamine will exert significant 1 activity at lower doses! If, for some reason, pacing is contraindicated or you cant pace the patient, consider Dopamine or Epinephrine as first line pressors. mg), as it may worsen the bradycardia.

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Epinephrine EMS OR ED 83

Broome Docs

NOVEMBER 17, 2024

PMID: 38857847 Bottom line: This before and after study demonstrates an association between early IM epinephrine and survival from cardiac arrest. PMID: 38857847 Bottom line: This before and after study demonstrates an association between early IM epinephrine and survival from cardiac arrest. Resuscitation. 2024 Aug;201:110266.

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Epinephrine Emergency Department Critical Care ICU 60