{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T06:16:52Z","timestamp":1772691412849,"version":"3.50.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"24","license":[{"start":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T00:00:00Z","timestamp":1720656000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>Vasoactive medications are used during advanced cardiac life support (ACLS) to shunt oxygenated blood to vital organs and after return of spontaneous circulation (ROSC) to maintain hemodynamic goals. However, limited evidence exists to support vasoactive medication recommendations in such scenarios, and it is unknown how practices vary among emergency departments across the US.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A survey questionnaire (15 questions) was electronically distributed to emergency medicine pharmacists (EMPs) in the US through various professional listservs. Demographic information, American Heart Association ACLS algorithm medication use, and use of continuous vasopressor infusions and adjunct medications following ROSC were assessed and are reported descriptively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The survey was distributed to 764 EMPs, with a 23% response rate from a wide geographic distribution and 48% of respondents practicing in academic medical centers. Epinephrine dosing and administration during cardiac arrest were reported by most to be in accordance with ACLS cardiac arrest algorithms. Calcium, magnesium sulfate, and sodium bicarbonate were the most common adjunct intravenous medications given during cardiac arrest. Norepinephrine was the first-choice vasopressor (81%) for post-ROSC hypotension, while epinephrine was preferred less frequently (17%). Antibiotics and sodium bicarbonate were the most frequently administered post-ROSC adjunct medications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This survey of a geographically diverse group of EMPs demonstrated high ACLS algorithm adherence for epinephrine during cardiac arrest with frequent additional administration of nonalgorithm medications. Sodium bicarbonate and calcium were the most frequently administered adjunct medications during cardiac arrest, while sodium bicarbonate and antibiotics were the most frequently used adjunct medications following ROSC. Norepinephrine was the most commonly used vasopressor following ROSC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxae186","type":"journal-article","created":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T19:26:11Z","timestamp":1720725971000},"page":"1313-1321","source":"Crossref","is-referenced-by-count":2,"title":["A national survey of medication utilization for cardiac resuscitation in the emergency department: A survey of emergency medicine pharmacists"],"prefix":"10.1093","volume":"81","author":[{"given":"Lance","family":"Ray","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Denver Health and Hospital Authority , Denver, CO"},{"name":"Department of Emergency Medicine, University of Colorado , Aurora, CO ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole M","family":"Acquisto","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Rochester Medical Center , Rochester, NY"},{"name":"Department of Emergency Medicine, University of Rochester Medical Center , Rochester, NY ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zlatan","family":"Coralic","sequence":"additional","affiliation":[{"name":"University of California San Francisco , San Francisco, CA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Feldman","sequence":"additional","affiliation":[{"name":"Froedtert Hospital , Milwaukee, WI"},{"name":"Department of Clinical Sciences , Milwaukee, WI ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Mercer","sequence":"additional","affiliation":[{"name":"The University of Texas at Austin College of Pharmacy , Austin, TX"},{"name":"Department of Pharmacy, Houston Methodist West Hospital , Houston, TX ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David E","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Duquesne University School of Pharmacy , Pittsburgh, PA"},{"name":"University of Pittsburgh Medical Center\u2013Mercy , Pittsburgh, PA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gavin T","family":"Howington","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy , Lexington, KY"},{"name":"Department of Pharmacy Services, University of Kentucky HealthCare , Lexington, KY ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giles W","family":"Slocum","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Rush University Medical Center , Chicago, IL"},{"name":"Department of Emergency Medicine, Rush University Medical Center , Chicago, IL ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett","family":"Faine","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Iowa , Iowa City, IA"},{"name":"Department of Pharmacy, University of Iowa , Iowa City, IA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan A","family":"Rech","sequence":"additional","affiliation":[{"name":"Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital , Hines, IL"},{"name":"Department of Emergency Medicine, Loyola University Medical Center , Maywood, IL ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,7,11]]},"reference":[{"issue":"9","key":"2024121018582582600_CIT0001","doi-asserted-by":"publisher","first-page":"e139","DOI":"10.1161\/CIR.0000000000000757","article-title":"Heart disease and stroke statistics\u20132020 update: a report from the American Heart Association","volume":"141","author":"Virani","year":"2020","journal-title":"Circulation"},{"issue":"8","key":"2024121018582582600_CIT0002","doi-asserted-by":"publisher","first-page":"e93","DOI":"10.1161\/CIR.0000000000001123","article-title":"Heart disease and stroke statistics\u20132023 update: a report from the American Heart Association","volume":"147","author":"Tsao","year":"2023","journal-title":"Circulation"},{"issue":"18","key":"2024121018582582600_CIT0003","doi-asserted-by":"publisher","first-page":"1711","DOI":"10.1056\/NEJMoa1514204","article-title":"Amiodarone, lidocaine, or placebo in out-of-hospital cardiac arrest","volume":"374","author":"Kudenchuk","year":"2016","journal-title":"N Engl J Med"},{"issue":"8","key":"2024121018582582600_CIT0004","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1056\/NEJMoa1806842","article-title":"A randomized trial of epinephrine in out-of-hospital cardiac arrest","volume":"379","author":"Perkins","year":"2018","journal-title":"N Engl J Med"},{"issue":"22","key":"2024121018582582600_CIT0005","doi-asserted-by":"publisher","first-page":"1804","DOI":"10.1093\/eurheartj\/ehz120","article-title":"Early goal-directed haemodynamic optimization of cerebral oxygenation in comatose survivors after cardiac arrest: the Neuroprotect post-cardiac arrest trial","volume":"40","author":"Ameloot","year":"2019","journal-title":"Eur Heart J"},{"issue":"12","key":"2024121018582582600_CIT0006","doi-asserted-by":"publisher","first-page":"2091","DOI":"10.1007\/s00134-018-5446-8","article-title":"Targeting low-normal or high-normal mean arterial pressure after cardiac arrest and resuscitation: a randomized pilot trial","volume":"44","author":"Jakkula","year":"2018","journal-title":"Intensive Care Med"},{"issue":"1","key":"2024121018582582600_CIT0007","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1097\/CCM.0000000000003474","article-title":"Association between elevated mean arterial blood pressure and neurologic outcome after resuscitation from cardiac arrest: results from a multicenter prospective cohort study","volume":"47","author":"Roberts","year":"2019","journal-title":"Crit Care Med"},{"issue":"23","key":"2024121018582582600_CIT0008","doi-asserted-by":"publisher","first-page":"2452","DOI":"10.1161\/CIRCULATIONAHA.108.190652","article-title":"Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A consensus statement from the International Liaison Committee on Resuscitation (American Heart Association, Australian and New Zealand Council on Resuscitation, European Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Asia, and the Resuscitation Council of Southern Africa); the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; and the Stroke Council","volume":"118","author":"Neumar","year":"2008","journal-title":"Circulation."},{"key":"2024121018582582600_CIT0009","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.resuscitation.2017.01.007","article-title":"Impact of mean arterial pressure on clinical outcomes in comatose survivors of out-of-hospital cardiac arrest: insights from the University of Ottawa Heart Institute Regional Cardiac Arrest Registry (CAPITAL-CARe)","volume":"113","author":"Russo","year":"2017","journal-title":"Resuscitation"},{"issue":"24 suppl","key":"2024121018582582600_CIT0010","doi-asserted-by":"publisher","first-page":"IV-78","DOI":"10.1161\/CIRCULATIONAHA.105.166559","article-title":"Part 7.4: Monitoring and medications","volume":"112","year":"2005","journal-title":"Circulation"},{"issue":"16 suppl 2","key":"2024121018582582600_CIT0011","doi-asserted-by":"publisher","first-page":"S366","DOI":"10.1161\/CIR.0000000000000916","article-title":"Part 3: Adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care","volume":"2020","author":"Panchal","journal-title":"Circulation"},{"key":"2024121018582582600_CIT0012","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.resuscitation.2021.02.003","article-title":"European Resuscitation Council guidelines 2021: executive summary","volume":"161","author":"Perkins","year":"2021","journal-title":"Resuscitation"},{"key":"2024121018582582600_CIT0013","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.ajem.2023.12.031","article-title":"Norepinephrine versus epinephrine for hemodynamic support in post-cardiac arrest shock: a systematic review","volume":"77","author":"Lawson","year":"2024","journal-title":"Am J Emerg Med"},{"key":"2024121018582582600_CIT0014","author":"EMPHARM-NET"},{"issue":"10","key":"2024121018582582600_CIT0015","doi-asserted-by":"publisher","first-page":"3179","DOI":"10.1007\/s11606-021-06737-1","article-title":"A consensus-based checklist for reporting of survey studies (CROSS)","volume":"36","author":"Sharma","year":"2021","journal-title":"J Gen Intern Med"},{"issue":"4","key":"2024121018582582600_CIT0016","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1345\/aph.1K475","article-title":"Association of pharmacist presence on compliance with advanced cardiac life support guidelines during in-hospital cardiac arrest","volume":"42","author":"Draper","year":"2008","journal-title":"Ann Pharmacother"},{"issue":"3","key":"2024121018582582600_CIT0017","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1093\/ajhp\/zxaa378","article-title":"ASHP Guidelines on Emergency Medicine Pharmacist Services","volume":"78","author":"Ortmann","year":"2021","journal-title":"Am J Health-Syst Pharm"},{"issue":"10","key":"2024121018582582600_CIT0018","doi-asserted-by":"publisher","first-page":"1337","DOI":"10.1016\/j.resuscitation.2014.06.032","article-title":"Use of esmolol after failure of standard cardiopulmonary resuscitation to treat patients with refractory ventricular fibrillation","volume":"85","author":"Driver","year":"2014","journal-title":"Resuscitation"},{"key":"2024121018582582600_CIT0019","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.resuscitation.2016.07.243","article-title":"Refractory ventricular fibrillation treated with esmolol","volume":"107","author":"Lee","year":"2016","journal-title":"Resuscitation"},{"issue":"2","key":"2024121018582582600_CIT0020","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.jacc.2018.04.051","article-title":"Epinephrine versus norepinephrine for cardiogenic shock after acute myocardial infarction","volume":"72","author":"Levy","year":"2018","journal-title":"J Am Coll Cardiol"},{"issue":"9","key":"2024121018582582600_CIT0021","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1056\/NEJMoa0907118","article-title":"Comparison of dopamine and norepinephrine in the treatment of shock","volume":"362","author":"De Backer","year":"2010","journal-title":"N Engl J Med"},{"issue":"11","key":"2024121018582582600_CIT0022","doi-asserted-by":"publisher","first-page":"e1063","DOI":"10.1097\/CCM.0000000000005337","article-title":"Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2021","volume":"49","author":"Evans","year":"2021","journal-title":"Crit Care Med"},{"issue":"8","key":"2024121018582582600_CIT0023","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1177\/0885066620917630","article-title":"Vasopressor and inotrope therapy in cardiac critical care","volume":"36","author":"Jentzer","year":"2021","journal-title":"J Intensive Care Med"},{"issue":"18","key":"2024121018582582600_CIT0024","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1056\/NEJMra1208943","article-title":"Circulatory shock","volume":"369","author":"Vincent","year":"2013","journal-title":"N Engl J Med"},{"key":"2024121018582582600_CIT0025","doi-asserted-by":"crossref","DOI":"10.1002\/9781394260645","volume-title":"Internet, Phone, Mail, and Mixed-Mode Surveys: The Tailored Design Method","author":"Dillman","year":"2014","edition":"4"}],"container-title":["American Journal of Health-System Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article-pdf\/doi\/10.1093\/ajhp\/zxae186\/58742944\/zxae186.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/81\/24\/1313\/60956225\/zxae186.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/81\/24\/1313\/60956225\/zxae186.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T19:56:55Z","timestamp":1733860615000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajhp\/article\/81\/24\/1313\/7712380"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,11]]},"references-count":25,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2024,7,11]]},"published-print":{"date-parts":[[2024,12,5]]}},"URL":"https:\/\/doi.org\/10.1093\/ajhp\/zxae186","relation":{},"ISSN":["1079-2082","1535-2900"],"issn-type":[{"value":"1079-2082","type":"print"},{"value":"1535-2900","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,12,15]]},"published":{"date-parts":[[2024,7,11]]}}}