The Push Dose Pressor Bridge

So we have pretty much all heard the craze on Push Dose Pressors (PDP) amongst the FOAMed chatter. Dr. Weingart took an old anesthesia trick used in the OR, and applied it to resuscitative medicine in the emergency room. In EMcrit episode 6 he discusses the expected lag time between ordering a pressor, receiving the infusion from pharmacy, and the drug actually getting into the patient. When MAP is critically low, this lag time can be detrimental to end organ perfusion. This is where PDP comes in handy. Every hospital has a code cart with cardiac epi at its disposal. A reduction of concentration to 100mcg in 100cc’s allows the much needed pressor support to bridge the lag time of pharmacy delivering your pressor infusion.

So what’s the issue?