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Cardiac arrest
Early adrenaline + early airway in OHCA
The Benefit of Early Advanced Airway Management Depends on Prehospital Epinephrine Timing in Out-of-Hospital Cardiac Arrest: A Nationwide Cohort Study
The Journal of Emergency Medicine · Added 2 October 2026
Korean nationwide registry cohort of 20,662 OHCA patients testing whether early adrenaline (≤10 min) combined with early advanced airway management (≤6 min) improves outcomes — the combination roughly doubled odds of good neurological recovery (aOR 2.44) and survival to discharge (aOR 2.18) versus late/late, and early adrenaline with late airway showed no benefit, but the interaction attenuated in sensitivity analyses addressing resuscitation time bias, so it is hypothesis-generating rather than confirmatory.
- Study type
- Registry
- Design
- Retrospective national registry cohort (Korea OHCA Registry)
- Participants
- 20,662 adults with OHCA receiving prehospital adrenaline and advanced airway management
- Main finding
- Early adrenaline (≤10 min) + early airway (≤6 min) vs late/late: good neurological recovery aOR 2.44 (95% CI 1.93–3.08), survival to discharge aOR 2.18 (95% CI 1.87–2.55); early airway with late adrenaline no benefit (aOR 0.99); interaction attenuated in sensitivity analyses
- Caveat
- Retrospective registry data with resuscitation time bias; interaction not robust in sensitivity analyses; Korean setting
- Bottom line
- Hypothesis-generating
Why it matters in Australia (Medium relevance). Adrenaline and advanced airway are core ACTAS scope (adrenaline AP-wide, SGA at AP level, intubation ICP-only), but this is retrospective registry data with an acknowledged time-bias caveat and Korean EMS system timings differ from ours.
Learning goal
Weigh the benefits and risks of combining early adrenaline with early advanced airway management in out-of-hospital cardiac arrest.
More
- Topic: Cardiac arrest
- Daily scan: 2 October 2026
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