After a century, Epinephrine's role in cardiac arrest resuscitation remains controversial

Epinephrine is recommended in contemporary educational efforts by the American Heart Association (AHA) as central to adult Advanced Cardiac Life Support (ACLS). However, International Liaison Committee on Resuscitation (ILCOR) 2019 recommendations update describes large evidentiary gaps for epinephrine use cardiopulmonary resuscitation, highlighting that clinical and experimental evidence do not support current AHA recommendations. This controversies article was written a response updated ILCOR ACLS late 2019. report summarizes evaluates surrounding cardiac arrest with focus historical perspective of research. According guidelines, an integral component out-of-hospital resuscitation. improves rates return spontaneous circulation might provide benefit at different doses or select resuscitation scenarios, such asystole initial rhythm onset efforts. indicates potential harms routine standard dose (1 mg/10 mL), no improvement neurologic long-term outcomes. Despite years inclusion associated improved The Emergency Cardiovascular Care committee should revise guidelines reflecting standard-dose offers little successful patient recovery including Future reflect this important consideration.