Advancing Nursing Practice (An evaluation of pharmacological options for hypotension in a prehospital environment)
As SORT are 10minutes away and include time to extricate him and take him to hospital under emergency conditions is going to be about 45minutes to an hour decide to start initial sepsis management to try and improve his GCS thus stabilising him and hopefully mean that he is able to cooperate and assist with extrication out of flat. We give him Saline an antibiotic (ceftriaxone) oxygen etc however is still hypotensive with following Saline. We decide we need to use a pharmacological agent to increase his BP and the consultant asks me to use Meteraminol however this is carried in the secondary bag and not the primary drug bag and the options we have are ephedrine or adrenaline. The consultant says that they do not use ephedrine often and prefers metaraminol however we use it and get a slight improvement in BP and GCS remains stable. He is eventually extricated and conveyed to the local Emergency Department where he is given metaraminol and admitted to ICU. Meteraminol is frequently used by EMRS during secondary transfers and is a drug that all clinicians are confident and happy to use. This essay will discuss vasopressors and whether it would be advisable to include Meteraminol or something else in the prehospital drug bag aswell as the secondary drug bag.
