Which statement best reflects the current status of atropine in the adult cardiac arrest algorithm?

• A Atropine is no longer recommended for routine use in asystole or PEA ✓
• B Atropine 3 mg IV remains the first drug given in asystole
• C Atropine 0.5 mg IV is given alternately with adrenaline in PEA
• D Atropine is given only when the arrest follows spinal cord injury

Explanation

Atropine was removed from the cardiac arrest algorithm because evidence showed no benefit for survival to discharge in asystole or PEA; these rhythms are rarely caused by excess vagal tone. Adrenaline 1 mg every 3 to 5 minutes remains the sole routine arrest drug alongside specific therapy for reversible causes. Atropine retains its role in symptomatic bradycardia with a pulse, where 1 mg IV may be repeated to a maximum of 3 mg.

Reference: AHA Guidelines for CPR and Emergency Cardiovascular Care, 2020 ed.

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Written and medically reviewed by the StethoPrep medical team.