Goldilocks in Cardiac Arrest: A Scoping Review of Invasive Hemodynamic Monitoring in the Pre-Hospital Setting for Getting Adrenaline Dosing Just Right

Introduction A one-size-fits-all approach to adrenaline dosing is likely be sub-optimal for out-of-hospital cardiac arrest given the diverse nature of patient age, bodyweight, frailty and intra-arrest coronary perfusion pressure. An individualised using invasive blood pressure monitoring has been shown increase rates return spontaneous circulation in hospital setting, but evidence this not yet reviewed pre-hospital setting. Methods scoping review was undertaken Science Direct, ProQuest, PubMed, CINAHL Complete GALE Health Wellness databases with search terms ‘arterial line’, ‘pre-hospital’, ‘cardiac arrest’ similar derivatives. Subject matter experts authors articles meeting inclusion criteria were also consulted help identify further relevant studies. Articles included if they pertained use arterial lines field, excluded related traumatic arrest, a language other than English, Dutch or French, retrievable as full text. Results total 1408 identified method, which three remained after de-duplication, exclusion criteria, text appraisal. The current literature lacking avenues research improve hemodynamic guided resuscitation identified. Conclusion Paramedic-initiated presents new, unproven, intervention improving outcomes.