Epinephrine produces beneficial effects in patients during cardiac arrest, primarily because of its alpha-adrenergic (ie, vasoconstrictor) effects.S6-1 These alpha-adrenergic effects can increase coronary and cerebral perfusion pressure during CPR. The value and safety of the beta-adrenergic effects of epinephrine are controversial because they may increase myocardial work and reduce One trial assessed short-term and longer-term outcomes when com- paring standard-dose epinephrine to placebo.S6-23 Standard-dose epinephrine was defined as 1 mg given intravenously or intraosseously every 3 to 5 minutes. For both survival to discharge and sur- vival to discharge with good neurologic outcome, there was no benefit with standard-dose epi- nephrine; however, the study was underpowered for analysis of either of these outcomes. There was, nevertheless, improved survival to hospital admission and improved return of spontaneous circulation with the use of standard-dose epi- nephrine. A number of trials have compared out- comes of standard-dose epinephrine with those of high-dose epinephrine. These trials did not demonstrate any benefit for high-dose epineph- rine over standard-dose epinephrine in relation to survival to discharge with a good neurologic recovery, survival to discharge, or survival to hos- 11. Amiodarone was more effective than lidocaine in terminating incessant VT with improved survival CLINICAL STATEMENTS AND GUIDELINES For patients with recurrent, sta- ble VT not in the setting of an AMI, intravenous procainamide has been shown to be superior to lidocaine for terminating the arrhythmia.S6-11 One RCT in 62 patients found procainamide superior to amiodarone for termination of stable VT.S6-13 Adverse events, including hypotension, were more common with amiodarone, but the differ- ence was not statistically signficant. Procainamide and its metabolite n-acetylprocainamide have potassium channel blocking properties that may prolong the QT interval. 