title: Quick epinephrine administration induces favorable neurological outcomes in out-of-hospital cardiac arrest patients.
abstract: OBJECTIVE
  This research is to study if quick administration of adrenaline on OHCA prior to hospitalization has an effect on improving CPC1-2 at one month.
  
  
  METHODS
  A total 13,326 cases were extracted from 2011 to 2014 Utstein data for this retrospective cohort study, also, EMT reached the patients within 16min after 119 called and adrenaline was then administered within 22min of after contact.
  Patients were contacted within 8min of the 119 call (n=6956), and were contacted between 8 and 16min after the call (n=6370). Further divided into groups in which the adrenaline was administered within/without 10min after contact. Primary outcome was the rate of a good prognosis for cerebral performance (CPC1-2) at 1 month and secondary outcome was the return of spontaneous circulation (ROSC) rate.
  
  
  RESULTS
  The odds ratio of the CPC1-2 at 1month by the EMS reached within 8min after 119 call and then adrenaline administered within 10min was 2.12 (1.54-2.92).Those reached between 8 and 16min was 2.66 (1.97-3.59). However, the ROSC rate was 2.00 (1.79-2.25) for those reached within 8min and also 2.00 (1.79-2.25) for those reached between 8min and 16min.
  
  
  CONCLUSIONS
  In cases of OHCA, it appears that the CPC1-2 rate after 1month can be improved even in cases where the victim is reached >8min after the 119 call, as long as the victim is reached within 16min and emergency responders administer the adrenaline as quickly as possible.
authors.affiliation: Department of EMS System, Graduate School, Kokushikan University. Electronic address: hueta@kokushikn.ac.jp.
authors.forename: H
authors.initials: H
authors.lastname: Ueta
authors.affiliation: Department of EMS System, Graduate School, Kokushikan University. Electronic address: hidetana@kokushikan.ac.jp.
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Research institute of Disaster preparedness EMS and Rescue Institute, Kokushikan University.
authors.forename: S
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of EMS System, Graduate School, Kokushikan University.
authors.forename: R
authors.initials: R
authors.lastname: Sagisaka
authors.affiliation: Department of EMS System, Graduate School, Kokushikan University.
authors.forename: H
authors.initials: H
authors.lastname: Takyu
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D004632:Emergency Medical Services; D004837:Epinephrine / Q000008:administration & dosage* / Q000627:therapeutic use; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D002534:Hypoxia, Brain / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D007564:Japan; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D014662:Vasoconstrictor Agents; D004837:Epinephrine
keywords: 1-month favorable neurological outcome; Early epinephrine administration; OHCA; Paramedic; ROSC; Time-limited effect