Authors’ Disclosure Statement: The authors report no actual or potential conflict of interest in relation to this article.
Dr Weigand is a senior resident, department of emergency medicine, University of Virginia School of Medicine, Charlottesville. Dr Hedrick is a clinical pharmacist, emergency department, University of Virginia Health System, Charlottesville. Dr Brady is a professor of emergency medicine, department of emergency medicine, University of Virginia School of Medicine, Charlottesville.
Bolus-dose vasopressor therapy is a potentially very useful treatment in the ED and other emergency/critical care settings. However, despite its benefits in treating patients in shock or with hypoperfusion, PDP is not widely used in EM due to the lack of studies, reviews, and guidelines in the literature to support its use in the ED. Such a literature base is required to provide an appropriate, safe means of patient selection, medication choice, dosing, and administration. Continued educational and research efforts are needed to more fully explore the use of PDP therapy in the ED.
When used correctly and appropriately, PDP has promise to be an important aid in the management of shock in the ED. Although bolus-dose therapy is appropriate for select clinical scenarios involving significant shock states which have the potential for progression to complete CV collapse without timely therapy, it is an adjunct to, not a replacement for commonly employed and medically indicated therapies such as crystalloid bolus or continuous vasopressor infusions.
