Vasopressor Administration via Peripheral Intravenous Access for Emergency Department Stabilization in Septic Shock Patients.

Background: Septic shock is commonly treated in the emergency department (ED) with vasopressors. Prior data have shown that vasopressor administration through a peripheral intravenous line (PIV) is feasible.

Objectives: To characterize vasopressor administration for patients presenting to an academic ED in septic shock.

Commotio Cordis Resulting from Sibling Rivalry.

A 17-year-old girl with no significant medical, surgical, or family history presented to the emergency department following an episode of sudden cardiac arrest after being punched in the chest by her brother. Bystander CPR was immediately initiated, and she was found to be in ventricular fibrillation by emergency services. The patient had return of spontaneous circulation after one defibrillation event.

Feasibility of bystander-administered naloxone delivered by drone to opioid overdose victims.

Background: Currently, ≤5% of bystanders witnessing an opioid overdose (OD) in the US administer antidote to the victim. A possible model to mitigate this crisis would be a system that enables 9-1-1 dispatchers to both rapidly deliver naloxone by drone to bystanders at a suspected opioid OD and direct them to administer it while awaiting EMS arrival.

Methods: A simulated 9-1-1 dispatcher directed thirty subjects via 2-way radio to retrieve naloxone nasal spray from atop a drone located outside the simulation building and then administer it using scripted instructions.

Utilization and extravasation of peripheral norepinephrine in the emergency department.

Objective: Vasopressors are typically administered through central venous catheters (CVC) due to a historical risk of extravasation with peripheral administration. However, CVC insertion is a time-consuming process that may delay vasopressor administration and is associated with complications. The Virginia Commonwealth University Health System (VCUHS) Emergency Department (ED) implemented a protocol that recommends peripheral norepinephrine (pNE) be administered through an 18 gauge or larger at or above the antecubital fossa or the external jugular vein with a maximum dose of 20 μg/min.