During cardiac arrest due to VF/VT in ACLS, what is the standard IV epinephrine dose and interval?

• A. 2 mg IV every 3–5 minutes during CPR
• B. 1 mg IV every 3–5 minutes during CPR
• C. 0.5 mg IV every 5 minutes during CPR
• D. 1 mg IV every 1 minute during CPR

Answer: (B)

During cardiac arrest from VF/VT, epinephrine is used to raise perfusion pressure in the heart and brain while CPR is ongoing. The standard approach is a 1 mg IV bolus given every 3–5 minutes during CPR. This dosing interval fits with rhythm checks and does not delay defibrillation, which remains essential for shockable rhythms. The alpha-adrenergic effect of epinephrine raises diastolic aortic pressure, improving coronary and cerebral blood flow and increasing the chance of return of spontaneous circulation, while the beta effect supports some perfusion but can also raise heart rate and myocardial oxygen demand. Doses or intervals outside this range—such as 2 mg, or 1 mg every minute, or 0.5 mg every 5 minutes—are not supported because they either don’t provide additional benefit or increase the risk of adverse effects and do not improve outcomes.