“Peripheral Norepinephrine” By Dr. Salim Rezale

In addition to today’s resource, please see “Do You Know How to Pick a Vasopressor for Patients in Shock?” From CriticalCareNow
Posted on February 22, 2024 by Tom Wade MD

Today, I review, link to, and embed Dr. Salim Rezaie‘s Peripheral Norepinephrine.

All that follows is from the above resource.

Feb 12, 2024

Prospective observational study just published in CHEST February 2024 on the use of norepinephrine through a peripheral IV. Although the study doesn’t change much there are some very valuable lessons to take away.


1:07 Note that other authorities recommend that the peripheral IV be above the antecubital fossa. Note that Dr. Razaie later in today’s vidcast reports that he uses a concentration of NC Conc of 4 mg in 250 ml D5W.

1:54 There  are many different concentrations used.

2:15 Dr. Razaie, at his instution, uses a concentration of 4 mg of norepinephrine in 250 ml of D5W.

3:54 Here are the extravasation events that ocurred in the study.

4:10 Chart on extravasations:

5:03 Another chart on extravasation:

6:15 Key Components of the Study Protocol:

6:56 Dr. Rezaie’s extravasation bundle is on the Rebel EM site, REBEL Cast Ep73: Are Peripheral Vasopressors Safe?: [This podcast covers the same material that Dr. Rezaie’s YouTube video but is a seperate talk.]

7:17 And the next step is:

8:13 “And then the next thing we do is:


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