ArticleCritical care explorations2024
Current Emergency Medical Service Vasoactive Use for the Management of Shock.
Article in Critical care explorations, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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11 authors.
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Abstract
objectivesWe sought to describe the indications for vasoactive medication administration, hemodynamic treatment targets, and specific agents used by various international emergency medical service (EMS) providers. DESIGN AND
settingIn March 2022, we sent an online survey comprising of 20 questions to Medical Directors of EMSs across Australia, the Asia Pacific region, and North America. PATIENTS: A total of 108 EMS directors were emailed an invitation to participate.
interventionsNone. MEASUREMENTS AND MAIN
resultsTwenty-five EMS medical directors responded. Local site guidelines for vasoactive agent administration were available to 77.3% of providers. Epinephrine was commonly used as first-line vasoactive agent in 52% of questionnaire respondents, followed by norepinephrine (22%), dopamine (18%), and metaraminol (4%). Epinephrine was the most commonly used vasoactive agent across all forms of shock, with a higher proportion of utilization in cases of cardiogenic shock (58%) and patients suffering shock following cardiac arrest (56%).
conclusionsInternational EMS vasoactive use in the management of shock is heterogeneous. Future randomized controlled trials should aim to elucidate optimal prehospital treatment strategies for shock, including the initiation, choice of agent, and monitoring of vasoactive medication.
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