Summary

In this episode of the Overrun Podcast, Ed and Dan welcome intensivist Eddie Joe Gutierrez to discuss the use of vasopressors in emergency medical services (EMS). The conversation covers the challenges of peripheral IV access, the importance of early vasopressor administration in hypotensive patients, and the evolving understanding of fluid resuscitation in sepsis. Eddie emphasizes the significance of norepinephrine as a first-line vasopressor and compares it to phenylephrine, while also addressing the complexities of managing cardiogenic shock in the pre-hospital setting. In this conversation, Eddy Joe Gutierrez discusses critical aspects of managing shock and trauma in pre-hospital settings. He emphasizes the importance of understanding different types of shock, the role of vasopressors, and the challenges pre-hospital teams face. The discussion also covers the use of whole blood in trauma care and the growing interest in point-of-care ultrasound. Ultimately, the key takeaway is the urgency of restoring perfusion to patients as quickly as possible, with norepinephrine being the preferred vasopressor in many situations.

Takeaways

Chapters

00:00 Introduction to Vasopressors in EMS
02:49 Peripheral IV Access and Vasopressors
05:54 Early Use of Vasopressors in Hypotensive Patients
09:04 Fluid Resuscitation vs. Vasopressors in Sepsis
12:00 Understanding Norepinephrine and Its Mechanism
14:58 Comparing Vasopressors: Norepinephrine vs. Phenylephrine
17:57 Cardiogenic Shock and Its Management
20:21 Understanding Shock: A Clinical Perspective
24:07 Trauma Management and Whole Blood Administration
26:56 Point-of-Care Ultrasound in Pre-Hospital Settings
29:13 Vasopressors: Choosing the Right Agent
36:52 Restoring Perfusion: The Key Takeaway

Eddy Joe’s work can be found on Instagram @eddyjoemd

Buy his book here