Traditionally, vasopressor infusions have been done through central venous catheters (CVCs) due to the hypothetical risk of extravasation injury to extremities when given through peripheral IVs.
R.E.B.E.L. EM – Peripheral Pressors: 6 Pearls to Not F*#k Up the Arm Read More »
How should you use push-dose vasopressors in the ED? This post looks at the evidence behind their use and provides key points for patient care. As an added bonus, the post contains cards that can be printed for easy use on shift.
Push-Dose Vasopressors: An Update for 2019 Read More »
Clay covers some big studies in this wrap-up on sepsis and IV fluids for migraines. You don’t want to miss the ANDROMEDA-SHOCK and CENSER trials!
Journal Feed Weekly Wrap-Up Read More »
Welcome back to Part II of the series on vasopressors. Part I discussed basic guidelines for pressor use, in addition to specific literature regarding “inopressors” (norepinephrine, epinephrine, and dobutamine). Part II will discuss “pure inotropes” (dobutamine and milrinone) and “pure vasopressors” (vasopressin and phenylephrine).
An Evidence-Based Approach to Pressors in Shock: Part II Read More »
We use vasopressor agents almost daily in the ED, but what’s the evidence behind these medications? Can we fine-tune our utilization of pressor agents? This is the first of a two part series evaluating pressor agents in shock.
An Evidence-Based Approach to Pressors in Shock: Part I Read More »
Vasopressor use in patients with sepsis has been studied extensively, with many calling for early, peripheral vasopressors. What is the literature behind this, and are patient outcomes affected? This post examines the studies for vasopressors in sepsis and more.
Septic shock: Who should be treated with early pressors? Read More »
Vasopressors are frequently used in critically ill patients with hemodynamic instability both in the emergency department (ED) as well as intensive care units (ICUs). Typically, vasopressors are given through central venous catheters (CVCs) as opposed to peripheral intravenous (PIV) access due to the concerns about adverse events (i.e. tissue ischemia/necrosis) associated with extravasation through PIVs.
R.E.B.E.L. EM – Mythbuster: Administration of Vasopressors Through PIV Read More »
“Despite the multitude of studies, the excellent results, and the commonplace use by anesthesiologists for decades, the use of push-dose pressors has not yet made its way into standard emergency medicine practice”
For a patient in shock, or with anticipated instability during procedural sedation, push-dose pressors can be a lifesaver. Brendon Browning, DO covers administration of pressors under circumstances in which central lines and infusions either aren’t available or aren’t needed.
Push-Dose Pressors Read More »