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This was a multicenter retrospective cohort study over 6 years at 7 level one and two trauma centers.
1631 patients who had out of hospital traumatic cardiac arrest were included. The majority of the patients were adults, female, suffered penetrating trauma (64%) and were in a non-shockable rhythm. Prehospital epinephrine was given to 54% of patients.
Overall, survival to hospital discharge was lower in the epinephrine group (5% vs 16%). In the penetrating trauma subgroup, there was no statistically significant survival difference in patients who received epinephrine and those who did not.
EMS jurisdictions should examine their trauma arrest protocols and consider excluding the use of epinephrine. Several states, such as Maryland, have already removed epinephrine from the trauma arrest protocol.
References
Witt CE, Shatz DV, Robinson BRH, Campion EM, Shapiro ML, Bui EH, Meizoso JP, Dorlac WC. Epinephrine in Prehospital Traumatic Cardiac Arrest-Life Saving or False Hope? Prehosp Emerg Care. 2025 Feb 12:1-9. doi: 10.1080/10903127.2025.2461283. Epub ahead of print. PMID: 39889233.