Levophed Assisted Transfusion

There is an internal clock that begins ticking when I see a patient with a MAP below 65. That ticking gets even louder when the patient has a known head bleed. As clinicians we have several ways to raise someones mean arterial pressure:

Fill The Tank: Fluids and blood products.

Manipulate The Pump Dynamics: Inotropes and chronotropes .

Change The Size or Compliance of The Container: Vasopressors and regional occlusion (REBOA).