To the Editor The study by Dr Andersen and colleagues1 found an association between delayed administration of epinephrine and poorer survival rates after in-hospital pediatric cardiac arrest.
There are at least 3 possible scenarios for delivering epinephrine: the patient might already have a functioning cannula or central line, venous access might be attempted during resuscitation, or epinephrine might be delivered by intraosseous injection. Epinephrine can be given quickly and reliably by intraosseous injection, but clinicians could preferentially attempt intravenous administration first.
Poulton A, Chen F, Nanan R. Epinephrine Administration and Pediatric In-Hospital Cardiac Arrest. JAMA. 2016;315(4):416-417. doi:10.1001/jama.2015.16449