Investigating the effect of time between the onset of out-of-hospital cardiac arrest and adrenaline administration on patient outcome

Abstract

Background: Adrenaline is a drug that increases the likelihood of return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA), but there is insufficient ev-idence of effectiveness of the time from onset of cardiac arrest to adrenaline administra-tion on outcomes in prehospital care.

Objective and Methods: In this study, we examined how the timing from the onset of cardiac arrest to administration of adrenaline affects the outcome of OHCA injured pa-tients in a community protocol-based EMS unit. An observational study was conducted in Kihoku MC, Wakayama Prefecture (April 2021-March 2022), using a validation form based on the Utstein form, and 206 OHCA cases aged 8 years or older who were indicated for the drug protocol were selected. RESULTS: 74 (35.9%) received adrenaline, but return of spontaneous circulation (ROSC) resumed in only 49 (23.8%) and neurological prognosis was good (CPCOPC:1or2) in 9 (4.4%). The median time for cases in which adrenaline was administered was at least 20 minutes after the onset of cardiac arrest.

Conclusion: On-site adrenaline administration did not show a clear association between timing of administration and ROSC or good neurological prognosis compared to the no-dose group.