Related Experiment Video
Updated: Jun 6, 2025

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Current Emergency Medical Service Vasoactive Use for the Management of Shock
Jason E Bloom1,2, Vishal Goel3,4, David Anderson5,6,7
1Department of Cardiology, The Alfred Hospital, Melbourne, VIC, Australia.
Objectives:
We 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 Setting:
In 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.
Interventions:
None.
Measurements And Main Results:
Twenty-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%).
Conclusions:
International 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.
More Related Videos
Related Concept Videos
Blood Pressure Imbalances and Circulatory Shock
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Adrenergic Agonists: Therapeutic Uses
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and...
Antihypertensive Drugs: Vasodilators
Drug Delivery: Enteral Route
Aortic Regurgitation IV: Nursing Management
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

