Epinephrine for Cardiac Arrest Patients Also Causing Brain Damage

For many decades, paramedics have treated urgent cardiac arrest victims with adrenaline to prevent their death. However, newly released information is suggesting that the drug used by these medical professionals when cardiopulmonary resuscitation (CPR) and electric shocks failed to work, only improves the chance of preventing death by a slim margin, but at the same time increases neurological harm among survivors by close to 100 percent.

Many scientists now hold to the view that the adrenaline used in these emergency situations, also referred to as epinephrine, may inflict damage on the blood vessels of the patient’s brain, leading to a vegetative state. Another possibility is that the brain itself can survive for a shorter period of time than the heart can without oxygen. Therefore, although the heart may be restarted, the brain, when restarted after a long period without oxygen, is likely to suffer permanent impairment.

Death occurs in nearly 9 out of 10 cases of the cardiac arrest events outside of a hospital of some 350,000 people a year in the U.S. These individuals have the best chance of surviving when given prompt care in the form of CPR and defibrillator shocks.

Epinephrine is used as the last option when these methods fail to resuscitate the patient. The drug is designed to quickly increase blood pressure with the intent to restart the heart.

If medical professionals fail to provide the expected standard of care in these emergency cardiac arrest situations, they can be subjected to a medical malpractice lawsuit.

Academic Emergency Medicine (AEM) Journal analysis

An Academic Emergency Medicine journal analysis which evaluated more than a dozen studies of some 656,000 cardiac arrest patients concluded there were no benefits to providing adrenaline/epinephrine injections to these patients outside of a hospital setting. The monitoring available within a hospital allows for better monitoring of patients who are given these injections.

New England Journal of Medicine report

The conclusion of the Academic Emergency Medicine analysis is undergirded by a study reported in the New England Journal of Medicine involving 8000 patients in the United Kingdom from 2014 two 2017. It discovered only a minor benefit to administering adrenaline shots in emergency cardiac arrest scenarios. As well, among those who survived their heart attack and received an adrenaline injection, 30.1 percent suffered severe neurological impairment. Only 18.7 percent of those who survived and did not receive an adrenaline shot suffered such impairment. The impairment referred to can include the inability to walk or walk without assistance, incontinence, and remaining in a bedridden condition.

Past research reveals that every minute lost in a cardiac arrest scenario equals a 10 percent reduced chance of patient survival.

Paramedics are trained to make three attempts at restarting the heart using a defibrillator before a last-ditch effort of injecting the patient with adrenaline is attempted. Typically, these attempts cover a span of 6 to 8 minutes.

In many cases, the brain suffers irreversible damage due to oxygen deprivation by the time the patient is given epinephrine. Only a negligent error performed by medical professionals when attempting to resuscitate may serve as grounds for a medical malpractice case.

As Clifton Callaway of the University of Pittsburgh Medical Center who is co-author of an editorial about the New England Journal of Medicine report explains, “One interpretation is that epinephrine can save the heart, but is too little, too late for the brain.”

The results of the study, according to the authors, demonstrate the vital importance of the public having CPR and defibrillation skills.

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