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VASOPRESSIN OR EPI WHATS YOUR CHOICE


lilmo63

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Well you should follow your protocols for one on use of the medications.

Anyone tell you why they are reluctant to use vasopressin?

As far as how we use them here the epi is usually given first because it is easily given via bristojet. Vasopressin here is supplied in vials, so it is usually the second medication pushed. We just replace the vasopressin with either the first or second round of epi. We also give it within 3-5 minutes or an epi, we don't wait a full ten minutes.

What do you mean by a suggestion of each?

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None of the services around me carry it to my knowledge. We were taught that it is a great first option, we just don't have access...

Dwayne

(Rid, not ignoring your response to my other post, I just don't have time in between clinicals to post anything very substantial until Wed, Thurs. Thanks for responding.)

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In what situation would you give vasopressin in 3-5 mins but wait 10 mins to redose epi?

Dwayne

Sorry for the confusion. Here we give a dose of vasopressin just like it was an epi. It is either the first or second dose followed three to five minutes later by an epi. Some texts say that vasopressin can be given and then ten minutes later start pushing epi.

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Here we give a dose of vasopressin just like it was an epi. It is either the first or second dose followed three to five minutes later by an epi. Some texts say that vasopressin can be given and then ten minutes later start pushing epi.

This reeks of "cookbook" providers. By using vasopressin "just like it was epi" you are not following the recommendations from the manufacturer or the current ECC guidelines. Beside not allowing the drug to work, have you had any success following this regimen? Is this outlined in your protocols? Did your medical direction sign off on this?

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We carry both at my service, and I think there are two reasons why vaso isn't used as much as epi:

1) My service buys vasopressin in 20 unit vials, which is a pain in the butt during a code because you have to draw up two vials worth of meds with a needle or blunt tip before you are ready to give the drug. 1:10,000 epi, by comparison, we have in quick-n'-easy 1mg jets. It is simply less trouble to use epi, and during a code that tends to make the difference.

2) Vaso is newer than epi, and truthfully I think a lot of medics are just used to the epi/atropine/lido regimen that they don't consider vasopressin when the time comes to make a choice. This isn't as much of an issue for newer medics such as myself, but even still I find myself using epi more often than vaso probably for reason #1.

...Actually come to think of it, I've never used vasopressin in the field. Maybe I will next time! haha

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