Perceptions and Barriers to Administering Vasopressors in the Prehospital Setting.
epinephrine
fluid-refractory shock
hypotension
norepinephrine
paramedic
prehospital emergency medicine
vasopressor
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
accepted:
25
09
2022
entrez:
2
11
2022
pubmed:
3
11
2022
medline:
3
11
2022
Statut:
epublish
Résumé
Introduction Vasopressor administration is a critical medical intervention for patients with hypotension in undifferentiated shock states. Over the years, prehospital care has advanced with protocols and training that allow paramedics in the field to administer a variety of vasopressors. The primary objective of this investigation was to evaluate vasopressor experience among paramedics with regard to preference as well as the barriers to its preparation and administration. Methods A cross-sectional survey of vasopressor use by nationally certified paramedics (NRPs) was performed. A 20-item questionnaire was constructed to capture the prehospital perceptions and barriers of dopamine infusion, norepinephrine infusion, and IV bolus "push-dose" epinephrine (PD-E). Data collection was carried out from June to September 2021. Results A total of 44 responses were obtained (response rate = 44%). All participants had experience using vasopressors and understood their medical indications. Overall, PD-E was the most common vasopressor used in the prehospital setting, and participants felt equally confident in "using" and "preparing" it. Participants felt less confident with "using" and "preparing" vasopressors that required channel setup and maintaining a flow rate. Younger paramedics with less than five years of experience were more eager to use norepinephrine if trucks were stocked with pre-mixed norepinephrine rather than the current formulation that required compounding. Conclusion This study provided preliminary data that evaluated perceptions of vasopressor use in the prehospital setting among paramedics in a large urban environment. Preference and barriers to its preparation and administration were surveyed. Further research is needed to identify the interventions to reduce barriers and allow paramedics to be less limited by logistical considerations when choosing vasopressors in the prehospital setting.
Identifiants
pubmed: 36321024
doi: 10.7759/cureus.29614
pmc: PMC9603066
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e29614Informations de copyright
Copyright © 2022, Quinn et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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