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Episode 188: Vasopressors

Core EM

Consider these medications if there are signs of end-organ dysfunction, there is a considerable delta in baseline BP, systolic is less than 90 and/or MAP is less than 65 Norepinephrine is a good pressor for a lot of the situations that we encounter in the emergency department, such as septic shock, undifferentiated shock and hypovolemic shock.

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SGEM#392: Shock Me – Double Sequential or Vector Change for OHCAs with Refractory Ventricular Fibrillation?

The Skeptics' Guide to EM

Research interests include simulation-based assessment, transport medicine, and critical care analgesia. first appeared on The Skeptics Guide to Emergency Medicine. Date: February 7, 2023 Reference: Cheskes et al. One issue that has not been covered on the SGEM is pad placement and double sequential external defibrillation.

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The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults

REBEL EM

1-4 The PDPs, phenylephrine and epinephrine, result in vasoconstriction and increased cardiac contractility. They can be associated with side effects such as reflex bradycardia, decreased stroke volume in phenylephrine, tachycardia and hypertension associated with epinephrine.

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Updates in the Management of Refractory Ventricular Tachycardia or Ventricular Fibrillation Arrest

ACEP Now

2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. 5 More recent literature defines “refractory” as VT or VF that is persistent or recurrent despite three shocks from a defibrillator, three rounds of epinephrine, and use of an antiarrhythmic (i.e.,

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Neurogenic Shock in Children

Pediatric EM Morsels

Both norepinephrine and epinephrine can be used. Epinephrine is key if there is significant bradycardia. Spinal shock is a phenomenon of transient, physiologic (rather than anatomic) complete loss of spinal cord function inferior to an injury. Refers to the Spinal Cord Function and Reflexes, not specifically hemodynamic issues.

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SGEM#350: How Did I Get Epi Alone? Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrests

The Skeptics' Guide to EM

Guest Skeptic: Dr. Neil Dasgupta is an emergency physician and ED intensivist from Long Island, NY, and currently an assistant clinical professor and Director of Emergency Critical Care […] The post SGEM#350: How Did I Get Epi Alone? Epinephrine is provided and you quickly place an advanced airway.

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Updates in High dose Insulin and Euglycemia Therapy (HIET) for the treatment of Beta-adrenergic Receptor and Calcium Channel Antagonists Overdose

Core EM

HIET improves contractility without increasing SVR, while vasopressin and epinephrine transiently increase SVR/MAP but worsen cardiac output in anesthetized dogs given propranolol (Holger 2007). Insulin versus vasopressin and epinephrine to treat β-blocker toxicity. Strong trend across different study designs for superiority of HIET.

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