Start Peripheral Vasopressors Early in Shock!

It has been dogmatically believed that prolonged infusion of any vasopressor mandates placement of a central line.  However, available evidence doesn’t support this. Diluted solutions of all catecholamines are safe (except Vasopressin) to be administered peripherally via a well functioning 18-20G IV or larger in forearm (no hand/wrist/AC) . No old IVs (>72 hrs) Know how […]

Acute Heart Failure and Cardiogenic Shock

There’s minimal or no role for the administration of loop diuretics (Furosemide/Lasix) early in the management of Acute Pulmonary Edema. The majority of patients aren’t volume overloaded. Immediate care should focus on Non-Invasive Positive Pressure Ventilation and administration of nitroglycerin. In patients with End Stage Renal Disease, dialysis is what’s ultimately going to fix the […]

Emergency Medicine Kenya Foundation