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Because the needles are so fine (29G-31G), they are unlikely to be significantly dulled by a single puncture of the vials rubber stopper

10.1093/humrep/der371 157 NailwalH.ChanF

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This underscores the importance of not only supplementing energy but also effectively regulating the accumulation of metabolic by-products

ACLS : : cardiac arrest epinephrine (IV push) is a primary drug used in treating cardiac arrest improves perfusion pressure to brain & heart (due to vasoconstrictor effects) improves cardiac output (due to increasing heart rate, contractility & AVN conduction) : bradycardia & post-cardiac arrest hypotension epinephrine can be given by IV infusion or via endotracheal tube improves blood pressure, perfusion pressure, heart rate, contractility & AVN conduction NOTE: As outlined in current ACLS protocols, atropine is more commonly preferred as a drug of choice for treating symptomatic bradycardia