In non-shockable arrest, which agent may be used as an alternative to the first dose of epinephrine?

In non-shockable arrest, which agent may be used as an alternative to the first dose of epinephrine?

• A. Epinephrine 1 mg IV
• B. Atropine 0.5 mg IV
• C. Vasopressin 40 units IV
• D. Dopamine 5 mcg/kg/min

Answer: (C)

In non-shockable arrest, the goal is to maximize cerebral and coronary perfusion during CPR. Vasopressin 40 units IV is used as an alternative to the first dose of epinephrine because it produces strong vasoconstriction through V1 receptors, increasing aortic diastolic and overall perfusion pressures even when the patient’s acidosis and depleted catecholamines would blunt the effect of epinephrine. This can help sustain circulation during chest compressions. The vasopressin dose is given as a single 40-unit IV dose in place of the first epinephrine dose, after which epinephrine 1 mg IV every 3–5 minutes is given per protocol.

In non-shockable arrest, the goal is to maximize cerebral and coronary perfusion during CPR. Vasopressin 40 units IV is used as an alternative to the first dose of epinephrine because it produces strong vasoconstriction through V1 receptors, increasing aortic diastolic and overall perfusion pressures even when the patient’s acidosis and depleted catecholamines would blunt the effect of epinephrine. This can help sustain circulation during chest compressions. The vasopressin dose is given as a single 40-unit IV dose in place of the first epinephrine dose, after which epinephrine 1 mg IV every 3–5 minutes is given per protocol.