On this episode Nicholas gives us a rundown in “Best Evidence Topic” aka BET format on how epinephrine effects neurological outcomes after ROSC. ROSC is an acronym that stands for Return Of Spontaneous Circulation, which is actually a bit of a misnomer as it refers to when we get a pulse back after doing CPR. There is emerging evidence about epinephrine’s effect on someone’s neurological impairment after receiving substantial doses during a resuscitation. We take a look at some of those new articles and compare the evidence.References:Jacobs IG, Finn JC, Jelinek GA, Oxer HF, Thompson PL. Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomised double-blind placebo-controlled trial. Resuscitation. 2011;82(9):1138-1143. doi:10.1016/j.resuscitation.2011.06.029.Tomio J, Nakahara S, Takahashi H, et al. Effectiveness of Prehospital Epinephrine Administration in Improving Long-term Outcomes of Witnessed Out-of-hospital Cardiac Arrest Patients with Initial Non-shockable Rhythms. Prehosp Emerg Care. 2017;0(0):1-10. doi:10.1080/10903127.2016.1274347.Hubble MW, Tyson C. Impact of Early Vasopressor Administration on Neurological Outcomes after Prolonged Out-of-Hospital Cardiac Arrest. Prehospital Disaster Med. January Ristagno G, Tang W, Sun S, Weil MH. Cerebral cortical microvascular flow during and following cardiopulmonary resuscitation after short duration of cardiac arrest. Resuscitation. 2008;77(2):229-234. doi:10.1016/j.resuscitation.2007.12.013.Olasveengen TM, Wik L, Sunde K, Steen PA. Outcome when adrenaline (epinephrine) was actually given vs. not given – post hoc analysis of a randomized clinical trial. Resuscitation. 2012;83(3):327-332. doi:10.1016/j.resuscitation.2011.11.011.