Thread by @Core_EM

Today we review our podcast on vasopressors with Dr. Catherine Jamin, Vice Chair of Operations and associate professor of emergency medicine at NYU, along with being triple boarded in emergency medicine, internal medicine, and critical care medicine.

Listen in on our discussion of this essential yet nuanced topic.

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Some quick basics..

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There are various reasons to start pressors outside of the textbook blood pressure cutoffs, keep these in mind as you assess your patient’s whole clinical picture..

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Norepinephrine is usually the first tool we reach for when it comes to vasopressors, this is how Dr. Jamin uses it for her patients..

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Often neglected in the ED, remember to turn on Vasopressin when norepinephrine doesn’t quite seem to be enough..

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Dr. Jamin encourages caution with Phenylephrine and prefers to use it primarily as a push dose pressor or as an infusion with her intubated and sedated patients who are hypotensive mainly due to sedative medications..

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When compared to norepi, Epinephrine is a reliably more potent agent for cardiac output.. however it’s important to remember that it’s behavior changes at different doses and it often comes with an increase in tachycardia and an iatrogenic increase in lactate..

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Lastly, this is Dr. Jamin’s approach to utilizing the above agents in refractory shock, keeping in mind that she prefers to keep phenylephrine on hand as a push dose pressor should she need it..

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For the full listen, head over to our site at or find us on Apple Podcasts, Google Podcasts, or Stitcher.

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