In adult post ROSC hypotension, which intervention is specified as the recommended management?

• A. Decrease Epinephrine Drip to 1 drop every 4 seconds
• B. Increase Epinephrine Drip to 1 drop every 2 seconds
• C. Begin a norepinephrine infusion at 0.05 mcg/kg/min
• D. Withhold epinephrine and observe

Answer: (A)

After ROSC, the goal is to support blood pressure and organ perfusion while avoiding excessive vasopressor effects. Epinephrine helps raise BP, but once perfusion improves you should step down the vasopressor rather than keep a high dose. Reducing the drip to a slower rate—such as 1 drop every 4 seconds—provides continued support with a lower risk of tachycardia, myocardial ischemia, or excessive vasoconstriction. Increasing the dose or starting a norepinephrine infusion would be for worsening or unresolved hypotension, and withholding epinephrine would risk inadequate perfusion. So dialing back the epinephrine infusion is the appropriate next step.