Letters Section Editor: Jody W. Zylke, MD, Senior Editor.
Author Affiliations: Department of Health Services Management and Policy, Kyushu University Graduate School of Medicine (Dr Hagihara and Mr Abe) (email@example.com), and Department of Emergency and Critical Care Center, Kyushu University Hospital (Dr Nagata), Fukuoka, Japan.
In Reply: Mr Andersen and colleagues were concerned that patients receiving epinephrine comprised a small fraction of the population. Since 2006, certified emergency lifesaving technicians have been permitted to administer epinephrine. The change in epinephrine administration policy during the study period might have contributed to the small fraction of out-of-hospital cardiac arrest patients receiving epinephrine. After the study, the number of such patients receiving epinephrine increased annually from 8124 in 2008 to 11 208 in 2009 and to 14 282 in 2010. We found no factors that suggested selection bias.
Hagihara A, Abe T, Nagata T. Use of Epinephrine for Cardiac Arrest Prior to Hospital Arrival—Reply. JAMA. 2012;308(1):29-31. doi:10.1001/jama.2012.5944