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Field Expedient Vasopressors During Aeromedical Evacuation: A Case Series from the Puerto Rico Disaster Response.
Hardwick, Jason M; Murnan, Sean D; Morrison-Ponce, Daphne P; Devlin, John J.
Afiliação
  • Hardwick JM; Department of Emergency Medicine,Navy Medical Center Portsmouth,Portsmouth,VirginiaUSA.
  • Murnan SD; Department of Emergency Medicine,Navy Medical Center Portsmouth,Portsmouth,VirginiaUSA.
  • Morrison-Ponce DP; Department of Emergency Medicine,Navy Medical Center Portsmouth,Portsmouth,VirginiaUSA.
  • Devlin JJ; Department of Emergency Medicine,Navy Medical Center Portsmouth,Portsmouth,VirginiaUSA.
Prehosp Disaster Med ; 33(6): 668-672, 2018 Dec.
Article em En | MEDLINE | ID: mdl-30409234
IntroductionEmergency physicians are using bolus-dose vasopressors to temporize hypotensive patients until more definitive blood pressure support can be established. Despite a paucity of clinical outcome data, emergency department applications are expanding into the prehospital setting. This series presents two cases of field expedient vasopressor use by emergency medicine providers for preflight stabilization during aeromedical evacuation to a hospital ship as part of the United States Navy disaster response in Puerto Rico. A critical approach and review of the literature are discussed.Case ReportTwo critically ill patients were managed in an austere environment as a result of the devastation from Hurricane Maria (Yabucoa, Puerto Rico; 2017). They both exhibited signs of respiratory distress, hemodynamic instability, and distributive shock requiring definitive airway management and hemodynamic support prior to aeromedical evacuation.DiscussionThe novel use of field expedient vasopressors prior to induction for rapid sequence intubation was successfully and safely employed in both cases. Both patients had multiple risk factors for peri-induction cardiac arrest given their presenting hemodynamics. Despite their illness severity, both patients were induced, transported, and ultimately admitted to the intensive care unit (ICU) in stable condition following administration of the field expedient vasopressors.Conclusion:Field expedient vasopressors were safely and effectively employed in an austere field environment during a disaster response. This case series contributes to the growing body of literature of safe bolus-dose vasopressor use by emergency physicians to temporize hypotensive patients in resource-constrained situations. HardwickJM, MurnanSD, Morrison-PonceDP, DevlinJJ. Field expedient vasopressors during aeromedical evacuation: a case series from the Puerto Rico disaster response. Prehosp Disaster Med. 2018;33(6):668-672.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome do Desconforto Respiratório / Broncodilatadores / Epinefrina / Tempestades Ciclônicas Tipo de estudo: Risk_factors_studies Limite: Aged / Female / Humans País/Região como assunto: Caribe / Puerto rico Idioma: En Revista: Prehosp Disaster Med Assunto da revista: MEDICINA DE EMERGENCIA Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome do Desconforto Respiratório / Broncodilatadores / Epinefrina / Tempestades Ciclônicas Tipo de estudo: Risk_factors_studies Limite: Aged / Female / Humans País/Região como assunto: Caribe / Puerto rico Idioma: En Revista: Prehosp Disaster Med Assunto da revista: MEDICINA DE EMERGENCIA Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos