Choosing the right route, intravenous access decisions for vasoactive drugs in PHRM

Dr Robbie Ley Greaves1

1Lifeflight Medicine

Biography:

Robbie is an Emergency Physician and a Consultant with Lifeflight Medicine and The Queensland Ambulance Service. He also works at the Prince Charles Hospital.

Abstract:

Introduction

Vasoactive drugs are one of the most commonly given medications we given when providing critical care to our patients in PHRM. With the extended time frames within the Australasian Retrieval environment and often time critical conditions how to balance the risk and time involved between Central Venous access and peripheral vasoactive drugs is a recurring challenge.

We have aimed to aid clinicians in this decision making by giving evidence to help make patient specific answers.

Methods

We will present the combined results of a range of research from our service, an initial three year retrospective review of over 1000 patients on vasoactives including over 400 on peripheral vasoactives. A prospective trial of 500 patients on peripheral vasoactives including inpatient follow up. Lastly balancing this against 5 years of data on our central line use and complications.

Results

Retrospective trial ( https://pubmed.ncbi.nlm.nih.gov/38423993/ ) showed no major events, the prospective trial pending publication showed similar. Our central line audit showed a complication rates above the hospital literature (pending full ethics and publication). We would aim to present safety data from over 1400 aeromedical patients to inform clinical decisions.

Conclusion

The risk profile of even high dose peripheral vasoactives, is often superior to central venous access in critically unwell aeromedical patients.