I know the answer to the first question (no pressors, volume replacement..... right?) But the second one I know, I know it but I'm stuck, can't remember it.
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You are right that the first answer is blood transfusion to replaced lost blood volume. If the patient remains hypotensive despite adequate volume resuscitation then you have some options.
Personally I use norepinephrine (Levophed) because it has peripheral vasoconstriction and some cardiac inotropic effects. If the patient is very tachycardic and you don't want any more beta action then you can choose phenylephrine which is a pure peripheral vasoconstrictor.
Epinephrine can be used but it will also give you tachycardia and tachyarrhythmias.
Many times in these situations you end up using multiple pressors in the acute setting until you can get surgical control of the bleeding and catch up with volume etc.
Personally I use norepinephrine (Levophed) because it has peripheral vasoconstriction and some cardiac inotropic effects. If the patient is very tachycardic and you don't want any more beta action then you can choose phenylephrine which is a pure peripheral vasoconstrictor.
Epinephrine can be used but it will also give you tachycardia and tachyarrhythmias.
Many times in these situations you end up using multiple pressors in the acute setting until you can get surgical control of the bleeding and catch up with volume etc.
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Epinepherine is advised because of its excellent vasoconstrictive properties.