Figure 1

Innsbruck vasopressor strategy during cardiopulmonary resuscitation. If basic life support does not result in spontaneous circulation, our strategy is to alternate between an initial injection of 1 mg epinephrine i.v. and a subsequent injection of 40 IU vasopressin i.v. every 3–5 minutes if return of spontaneous circulation does not occur, independently of the initial electrocardiographic (ECG) rhythm. In one study, not a single patient with asystole or pulseless electrical activity as the initial ECG rhythm survived to hospital discharge if ≥ 3 mg epinephrine were injected; ventricular fibrillation patients tolerated higher epinephrine dosages [7]. There is no clear evidence how many times a vasopressor should be given until cardiopulmonary resuscitation (CPR) efforts should be terminated if return of spontaneous circulation does not occur.