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Reimagining Resuscitation - Episode 4: Expanded use of EtCO2

Deprioritizing epinephrine in the order of interventions

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Reminder: Our fifth and final episode of this series, “Reimagining Resuscitation: Behind the Scenes of Rialto’s Breakthrough” will be a live webinar including a Q&A session on Dec. 8, 2020. Send your questions for Kevin Joles and Joe Powell to and register for the webinar here.

Medical intervention succeeds best when administered to or performed on the right patient at the right time, and the use of epinephrine in treating a victim of cardiac arrest is no different.

The first episode of this special video/podcast series, “Reimagining Resuscitation: Behind the Scenes of Rialto’s Breakthrough,” brought to you by EMS1 and Zoll, broke down four acceptable pauses in CPR. Episode 2 explained how to prevent hypoxia with apneic oxygenation, and Episode 3 focused on using the stretcher as a tool in heads-up CPR.

In Episode 4, Rialto Fire Department’s Joe Powell, MICP, EMSC; and Lawrence-Douglas County Fire and Medical’s Kevin Joles, NREMT-P, discuss where epi lives within the wheel of survival in the seven steps outlined in this advanced cardiac resuscitation toolkit.

Joe Holley, MD, FACEP, FAEMS, medical director for the State of Tennessee Department of Emergency Medical Services, and the Memphis and Shelby County Fire Departments, shares what research has revealed about perfusion and the physiological state in which epinephrine can be most effective.


Review the research cited by Dr. Holley: 

Perkins G, Ji C, Deakin C, et al. (July 18, 2018). A randomized trial of epinephrine in out-of-hospital cardiac arrest. New England Journal of Medicine