Critical Matters Peripheral vasopressors
Oct 23, 2025
Dr. Elizabeth Munroe, a pulmonary and critical care physician from Intermountain Health, shares her insights on peripheral vasopressor administration. She reveals how this method is shifting clinical practices, especially in sepsis management. The conversation includes historical perspectives on central lines, recent safety studies, and the CLOVERS trial’s findings. Munroe emphasizes the practicality of peripheral access for urgent needs and outlines strategies for safe administration. She advocates for open-mindedness in evolving medical practices underpinned by robust evidence.
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Start Peripherally If You Need Pressors Now
- Start a peripheral vasopressor when you need pressors now and lack central access to avoid harmful delay.
- Use peripheral initiation as a bridge and reassess need for central access later.
Choose A Large, Secure Peripheral Line
- Prefer a large, secure peripheral IV in the forearm or upper arm and confirm with ultrasound if available.
- Avoid small hand/wrist/foot sites and choose a line you trust for monitoring.
Keep Visual Monitoring And A Backup IV
- Do not assume the peripheral line must be dedicated, but ensure visual monitoring and a backup IV ready.
- Avoid tying many other infusions that could change flow and increase extravasation risk.
