"Understanding prehospital vasopressors: Dopamine, epinephrine or norepinephrine?"

Managing hypotension in the field can be tricky. While only about 1-2% of EMS patients (non-trauma) present with hypotension and shock, this small subset of patients carries an in-hospital mortality rate between 33-52% [1]. This means that vasopressors are not used often, but they are used on the sickest of patients. A practical understanding of what common vasopressors do, both the good and the bad, is important in guiding clinical treatment decisions.

Vasopressors, sometimes called just “pressors,” refers to a group of medications that are used primarily for their ability to vaso-constrict blood vessels. The term inotrope refers to a group of medications used primarily for their ability to improve cardiac output by increasing the force of contraction of the heart. While these terms mean different things, they are often used interchangeably. This reflects the fact that many of these drugs can be both vasopressors and inotropes."

While taught in Paramedicine this side of the business is rarely used in UK prehospital care. If you are planning on attending the UK/US Paramedic Bridge program or the CCP-C/FP-C this excellent article will help you through the complexity of pressors and the rare circumstances that they may be used.


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