Epinephrine has been a mainstay of cardiac arrest resuscitation. A Paramedic-2 study published in NEJM may alter that practice. In the multicenter, randomized, double-blind, placebo-controlled study, while patients who received epinephrine compared to saline had higher admission and 30-day survival rates, there was no difference in favorable neurologic outcomes.
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Exposure to early hyperoxia may also have an adverse impact to patient outcomes. A prospective cohort study conducted among six U.S. hospitals revealed post-arrest patients exposed to early hyperoxia, ie, in the emergency department, had much worse neurologic outcomes. Maintaining FiO2 levels between 92 and 97 percent can minimize the chance of hyperoxia.