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This weekend I learned what an intra-cardiac epinephrine is. Wish I could say it was from a 
or topic discussion... 
Nope, it was John Doe, 
w/ cc of traumatic arrest s/p lots and lots of 
wounds 
... so what is intra-cardiac EPI
1/...
#MedTwitter #TwitteRx
or topic discussion... Nope, it was John Doe, w/ cc of traumatic arrest s/p lots and lots of wounds ... so what is intra-cardiac EPI1/...
#MedTwitter #TwitteRx
Just as it sounds 
... EPI 
directly into the myocardium. Generally only used in ATLS after performing an ED thoracotomy in conjunction w/ manual cardiac compression
So here are a few clinical pearls I learned from John Doe
2/...
... EPI directly into the myocardium. Generally only used in ATLS after performing an ED thoracotomy in conjunction w/ manual cardiac compressionSo here are a few clinical pearls I learned from John Doe
2/...
[Dosing & Freq] = same as ACLS
1 mg Q 3-5min. 
There are pre-filled 
products specific for intra-cardiac use, but ISMP says 
d/t risk for errors. Also, there isn't great evidence on what volume to use... what does ur institution use?
3/...
The key differences are in the length & gauge Consider 21- or 22-gauge needle Length 1.5" closer to 3.5"... really, whichever you can 
faster Administer via rapid push directly into the L ventricle Cardiac massage should be ongoing! 4/...
Complications include:Coronary artery laceration, cardiac tamponade, pneumothorax, and can interrupt external chest compression/ventilation
Bottom Line
Same dose, different needle...& make sure ur 
to the internet in the trauma bay 
PMID: [16759407][10978796]
