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The debate of the best way to administer epinephrine in cardiac arrest continues. Pediatric arrests are different from adults in many ways, but some differences in arrest include 1) data supporting improved survival with early epinephrine administration and 2) less IVs are placed in children overall compared to adults making IO placement possibly quicker.
In this study, 739 patients were included with a median age of 1 year. The IO was used in 72% of patients and an IV was used in 27.6% of patients. There was no difference between survival to hospital discharge or prehospital ROSC between the two groups.
References
Okubo M, Komukai S, Izawa J, Chung S, Dezfulian C, Guyette FX, Lupton JR, Martin-Gill C, Owusu-Ansah S, Ramgopal S, Callaway CW. Intraosseous vs Intravenous Access for Epinephrine in Pediatric Out-of-Hospital Cardiac Arrest. JAMA Netw Open. 2025 Jun 2;8(6):e2517291. doi: 10.1001/jamanetworkopen.2025.17291. PMID: 40560587; PMCID: PMC12199053.