Under the revised medical arrest directive can hypothermic patients get Epi 1:10,000?

Thank you for your question. In hypothermic cardiac arrest, ACLS protocols still apply but with a twist based upon core temperature, as the colder the temperature the less or delayed the response to drugs and electricity. The revised guidelines recommend: 

• Less than 30 degrees Celsius - one dose of IV epinephrine, 
• Greater than 30 degrees Celsius - may use normal ACLS protocols but double the duration for shocks and doses, i.e. every 4 minutes for shocks and every 6-10 minutes for IV epinephrine,
• Over 35 degrees Celsius - it is business as usual.

So how does this apply to the ACP paramedic who does not have a rectal thermometer? If hypothermia is suspected - you can give one dose of epinephrine during transport. You may receive further direction from the Base Hospital Physician.