Push Dose Epinephrine Use in the Management of Hypotension During Critical Care Transport

Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors
Philip Stuart NawrockiBenjamin James Lawner

Abstract

Introduction: Hypotension is a critical event during the transport of critically ill patients. Push dose vasopressor use, though widely adopted by anesthesiologists, has only recently found use in the field of emergency medicine and may have utility in the management of out-of-hospital hypotension. This study aimed to characterize the hemodynamic effects and adverse events that occur following push dose epinephrine (PDE) administration by critical care transport (CCT) providers to correct documented hypotension. Methods: We performed a retrospective observational study of patients transported by a regional critical care transport service and who received PDE during transport to correct documented hypotension. Per protocol, 10-20 µg of 1:100,000 epinephrine was given intravenously every 2 min until: (1) the systolic blood pressure (SBP) was at least 90 mmHg, or (2) the mean arterial pressure (MAP) was 65 mmHg or greater. All patients were over 18 years of age and were transported between January 1, 2015 and December 31, 2016. Primary outcomes of interest were the primary diagnoses associated with PDE use, hemodynamic outcomes of the intervention, and adverse events. Results: During the study period 100 doses of push dose epineph...Continue Reading

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Citations

Jul 18, 2019·The Journal of International Medical Research·Mohammed A Al-MulhimLayla B Al-Qahtani
Mar 3, 2020·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Andrew D FisherSteven G Schauer
Jul 14, 2020·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Christopher CliffordAlex F Manini
Jul 5, 2019·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Jon B ColeBrian E Driver
Jul 6, 2021·The American Journal of Emergency Medicine·Francisco Martín-RodríguezRaúl López-Izquierdo
Jun 19, 2021·The American Journal of Emergency Medicine·Jeremy LacocqueKarl A Sporer
Jul 25, 2021·The American Journal of Emergency Medicine·Kyle A Weant, David M French
Sep 11, 2021·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Romain Jouffroy, Benoît Vivien
Jan 11, 2022·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Daniel P DavisMichael Levy

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