For all 4 long-term and short-term outcomes, we found 1 underpowered RCT that provided low-quality evidence (downgraded for selection and ascertainment bias) comparing SDE with placebo(Jacobs 2011, 1138) in 534 subjects. For the critical outcome of survival to discharge, there was uncertain benefit or harm of SDE over placebo (RR, 2.12; 95% CI, 0.75–6.02; P=0.16; absolute risk reduction [ARR], 2.14%; 95% CI, −0.91% to 5.38%, or 21 more patients/1000 survived with epinephrine [95% CI, 9 fewer patients/1000 to 54 more patients/1000 survived with epinephrine]). For the critical outcome of survival to discharge with good neurologic outcome (defined as CPC of 1–2), there was uncertain benefit or harm of SDE over placebo (RR, 1.73; 95% CI, 0.59–5.11; P=0.32; ARR, 1.4%; 95% CI, −1.5% to 4.5%, which translates to 14 more patients/1000 survived with a CPC score of 1 or 2 with epinephrine [95% CI, 15 fewer patients/1000 to 45 more patients/1000 survived with a CPC score of 1 or 2 when given epinephrine]). For the important outcome of survival to admission, patients who received SDE had higher rates of survival to admission (RR, 1.95; 95% CI, 1.34–2.84; P=0.0004; ARR, 12%; 95% CI, 5.7%–18.9%, which translates to 124 more patients/1000 survived to admission with epinephrine [95% CI, 57–189 more patients/1000 survived to admission]). For the important outcome of ROSC in the prehospital setting, 151 more patients/1000 achieved ROSC with epinephrine (95% CI, 90–212 more patients/1000 achieved ROSC with epinephrine) when compared with those who received placebo (RR, 2.80; 95% CI, 1.78–4.41; P