Administration of Adrenaline Post ROSC

Q. Why is administering adrenaline post ROSC not detailed in the adrenaline monograph but it is mentioned in the resuscitation section?

A. The 2015 RCUK guidelines advocate the use of adrenaline boluses to support the circulation in patients who have significant hypotension post-arrest: https://www.resus.org.uk/library/2015-resuscitation-guidelines/prehospital-resuscitation.

This was then adopted by the JRCALC guidelines. The absence of this detail in the JRCALC monograph does not preclude its use, as the resuscitation chapters do advise that this is appropriate practice. We have recommended that all Trusts develop local guidance with regards to this practice and that small aliquots of adrenaline can be administered once ROSC has been achieved.

There are no known or planned trials looking at the use of adrenaline boluses post-arrest. There is no new evidence since 2015 at the time of posting this Q&A.