I am interested in stimulating a discussion concerning the use of =
inotropic agents in the emergency department setting after fluid =
resuscitation for the acutely hypotensive and vasoconstricted patient =
(cold extremities and initially poor pulses) without a history of =
1. What is one's endpoint for fluid resuscitation? (i.e. normal blood =
pressure, urine output, pulse quality, cap refill, mental status, lung =
exam, or number of cc/kg ect)
2. What do people feel are the indications, absolute and relative, for =
inotropic support in the emergency department setting?=20
3. Are people willing to use inotropic agents via a peripheral IV? If =
so, is there a maximum dose of a specific agent one is willing to use? =20
4. Should inotropic agents be reserved for the patient with central =
access? If so, would one sedate a child to place a central line or =
would one feel that a child who is active enough to fight the placement =
of a central line, does not require inotropic support?
Thank you, in advance, for your response.
Rustin B. Morse, M.D.
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Children's Memorial Hospital
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