ArticleResuscitation plus2021
Intramuscular adrenaline for out-of-hospital cardiac arrest is associated with faster drug delivery: A feasibility study.
Article in Resuscitation plus, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 15 citations in OpenAlex.
- Article
- Intramuscular epinephrine in cardiac arrest: A systematic review.Resuscitation plus · 2025Review
- Delayed adrenaline administration prolongs adrenaline-to-ROSC interval in out-of-hospital cardiac arrest.British paramedic journal · 2025Article
- Improving vasopressor use in cardiac arrest.Critical care (London, England) · 2023Review
- A prospective observational study on impact of epinephrine administration route on acute myocardial infarction patients with cardiac arrest in the catheterization laboratory (iCPR study).Critical care (London, England) · 2022Observational
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly adrenaline administration is associated with return of spontaneous circulation (ROSC) and survival in out-of-hospital cardiac arrest (OHCA). Animal data demonstrate a similar rate of ROSC when early intramuscular (IM) adrenaline is given compared to early intravenous (IV) adrenaline.
aimTo evaluate the feasibility of protocolized first-dose IM adrenaline in OHCA and it's effect on time from Public Safety Access Point (PSAP) call receipt to adrenaline administration when compared to IO and IV administration.
methodsThis is a before-and-after feasibility study of adult OHCAs in a single EMS service following adoption of a protocol for first-dose IM adrenaline. Time from PSAP call to administration and outcomes were compared to 674 historical controls (from January 1, 2013-February 8, 2021) who received at least one dose of adrenaline by IV or IO routes.
resultsDuring the study period, first-dose IM adrenaline was administered to 99 patients (December 1, 2019-February 8, 2021). IM adrenaline was given a median of 12.2 min (95% CI 11.4-13.1 min) after the PSAP call receipt compared to 15.3 min for the IV route (95% CI 14.6-16.0 min) and 15.3 min for the IO route (95% CI 14.9-15.7 min) with a time savings of 3 min (95% CI 2-4 min). Rates of survival to hospital discharge appeared similar between groups: 10% for IM, 8% for IV and 7% for IO. However, results related to survival were underpowered for statistical comparison.
conclusionsWithin the limitations of a small sample size and before-and-after design, first-dose IM adrenaline was feasible and reduced the time to adrenaline administration.
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