Podcast 801: Push Dose Vasopressors

<p><strong>Contributor: Aaron Lessen, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">There are two common options for push-dose vasopressor: phenylephrine and epinephrine. Both have been studied in the setting of the OR, but are lacking data in emergency room utilization. </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">A recent retrospective study at one hospital compared the two options for effectiveness and safety. The data showed phenylephrine raised systolic pressure an average 26 points while epinephrine raised the systolic pressure higher, an average of 33 points.</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Additionally, the same study showed dosing errors were more common in epinephrine. The error rates were 13% and 2% when using premixed syringes of epinephrine and phenylephrine respectively. However, overall no increase in adverse outcomes were reported between the two drugs in this study. </span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Nam E, Fitter S, Moussavi K. Comparison of push-dose phenylephrine and epinephrine in the emergency department.</span> <em><span style="font-weight: 400;">Am J Emerg Med</span></em><span style="font-weight: 400;">. 2022;52:43-49. doi:10.1016/j.ajem.2021.11.033</span></p> <p><span style="font-weight: 400;">Weingart S. Push-dose pressors for immediate blood pressure control.</span> <em><span style= "font-weight: 400;">Clin Exp Emerg Med</span></em><span style= "font-weight: 400;">. 2015;2(2):131-132. Published 2015 Jun 30. doi:10.15441/ceem.15.010</span></p> <p> </p> <p><em><span style="font-weight: 400;">Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD</span></em></p> <p> </p> <p><span style="font-weight: 400;">The Emergency Medical Minute is excited to announce that we are now offering</span> <em><span style="font-