Vasopressin vs. Epi

Specialties Emergency

Published

Just curious as to how many of you have been using vasopressin instead of epi during codes? Personally, I've NEVER seen vasopressin used, and I'm not sure why; the one time dose would certainly be easier than continued doses of epi. I know they're teaching it in ACLS, and in my researching the subject, it seems the studies show it to be slightly more effective in 24 hour survival rates s/p code.

We keep it in our ER pharm, but don't stock it on our code carts. I don't know if the physicians don't like change or are there other reasons they're not using it? So if you're using it, enlighten me!

Now that I think about it, the same with amiodarone-I've seen it used maybe 2-3 times, the docs stick with lidocaine.

I have never seen Vasopressin used yet, although it was taught in my ACLS class last October.

Amiodarone is preferred over Lidocaine where I work...EMS does not carry it though. Cost is a big factor...

Specializes in Emergency Room.

doesn't vasopressin have a longer half-life than epi? just wondering.

Specializes in Emergency Room.

ps....our paramedics don't use amiodarone because it has to be refrigerated....although we stock it in our code carts nonrefrigerated. In phoenix it is too hot in the ambu's for amiodarone. Also heard that wyeth pharmaceuticals "donated" a few million dollars to the AHA for a new building, and suddenly the drug showed up in the new protocols. anyone heard of this?

Taught to use it...never have.... not yet. " THE FACT THAT 10 MINS IS A LONG TIME AFTER GIVING A DRUGTO SEE RESULTS. ":rolleyes:

If that IS the case I doubt we will ever use it.:p

We use a lot of amiodarone, and I've seen it do really well. I have never given vasopressin in a code yet. I think a lot of it has to do with the doctor's comfort level and knowledge base. However, in recent studies vasopressin was shown to only have a better success rate in getting a pt through the code. There was no increase in the percentage of pt's who actually made it out of the hospital after coding.

I know we've all seen the "dead" person with a booming carotid artery from all the epi we've given. It seems that vasopressin has an even bigger effect and will sustain a pulse a little longer than epi sometimes, but the pt's usually die at the same rate as they did before, those with vasopressin just took a little longer sometimes...

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