
ResusX:ReWired Volunteer

Dr. Salim Rezaie gave an amazing lecture last year during ResusX:ReWired. The pearls from the lecture are found below.
Check out the video, read the notes below, and then register here for ResusX:ReLoaded. The conference will be even bigger and better than ever before!
Use of peripheral pressors (particularly Norepinephrine) is ready for primetime and Dr. Rezaie gave six pearls to consider:
- #1 Choose Proximal veins
- Bigger diameter = Bigger target (easier to hit and less chances of back wall puncture)
- #2 Use Long catheter
- Longest catheter that will get you the most catheter into the vein: most of the time 4.78cm (1.88in)
- #3 Limit Time of Infusion
- 2 to 4 hours
- The longer you let it run, the more chance of extravasation
- #4 Use a Dilute Concentration + Small Volume
- 4mg Norepinephrine in 250mL volume
- #5 Have an Observation protocol
- Need not to be complicated
- As simple as someone (i.e. nurse) keeping an eye on the catheter site every 15 to 30 minutes
- #6 Must have an Extravasation protocol
- How Dr. Rezaie handles extravasation events:
> Disconnect the pressor and connect to a different site
> Leave the catheter in
> Connect a syringe to the catheter and suck out what you can
> Give any of the following:
Phentolamine: 5mg/mL x2 in 8mL NS = total volume 10mL (5mL into the catheter & 5mL subcutaneously)
Terbutaline: 1mg/mL in 9mL NS = total volume 10mL (5mL into the catheter & 5mL subcutaneously)
Other options: Nitro paste – not for hypotensive patients; Warm compress and arm elevation (avoid burning the skin)
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