When doctors are trying to start up a heart with a defibrillator when is epinephrine given is it during or only after the heart's started beating again?

First of all, they don't always use epinephrine. You need to understand that they aren't actually trying to "start up" the heart, they are trying to correct a serious cardiac arrythmia. Now, forget about everything you see in movies for a second, any medical show/ movie on TV is full of medical inconsistency.

See, defibrillators actually stop the heart's electrical activity rather than start it. The two conditions in which an external defibrillator is used are called Ventricular Fibrillation (V-Fib) and Ventricular Tachycardia (V-Tach). V-Fib is when the heart's electrical activity is completely disorganized and the heart is "twitching", V-Tach is basically when the heart is beating so fast that it is not moving blood.

Both situations, as you can imagine, are very serious. The defibrillator shocks the patient to the point where the heart's electrical activity stops, and since the heart makes its own electrical impulse, it will then hopefully restart itself So answering your question, epinephrine can be given in certain cases to attempt to help the heart restart itself. Usually an initial shock will be given beforehand but it will be given before other shocks if the heart does not restart itself the first time (which a LOT of times it does not).

But thinking back to what I said about V-Tach, you do not want to give epinephrine to a patient whose heart is beating too fast to begin with Sorry for the complex answer, but it's hard to answer a question like that without explaining some other things as well.

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