Push-Dose Epinephrine Utilization in the Emergency Department

Today's journal club will review a multicenter study analyzing the use of epinephrine in the emergency department.

So just a disclosure, I have no financial, personal, or commercial relationships related to the contents of this presentation.

Here is a list of abbreviations for your reference.

So the objectives for today's journal club presentation will be to describe the role in therapy and utility of push-dose vasopressors, examine study procedure and results, and summarize study conclusions and their applicability to practice.

So starting with the drug itself, epinephrine is a non-selective adrenergic ag-agonist.

It simulates alpha-1, beta-1, and beta-2 adrenergic receptors, resulting in relaxation of smooth muscle of the bronchial tree, cardiac stimulation, and dilation of skeletal muscle vasculature.

It does have dose-dependent activity, so at small doses, it has increased beta activity and decreased alpha activity.

So at smaller doses, you're gonna have more effect on heart rate and increased contractibility.

At high doses, you're gonna have increased alpha activity, which is gonna have more of an effect on blood pressure.