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Prehospital vasopressors in trauma unproven
Utility and outcomes of prehospital vasopressors infusion in trauma patients: a systematic review
European Journal of Emergency Medicine · 2026-09-24 · Added 3 October 2026
Systematic review of five retrospective studies (31,849 trauma patients) found prehospital vasopressor infusions before haemorrhage control showed inconsistent mortality associations — one military study found markedly lower adjusted survival and another linked vasopressors to more massive transfusion and coagulopathy — on very-low-certainty evidence.
- Study type
- Systematic review
- Design
- Systematic review of observational studies
- Participants
- 5 retrospective studies, 31,849 patients (1443 received vasopressors)
- Main finding
- Associations with mortality were mixed; one military study found significantly lower adjusted survival with vasopressors (aOR 0.32, 95% CI 0.18–0.56), and one study linked them to massive transfusion (aOR 4.97) and trauma-induced coagulopathy (aOR 3.05)
- Caveat
- Very-low-certainty retrospective data with substantial variation in vasopressor exposure and inevitable confounding by indication
- Bottom line
- Hypothesis-generating
Why it matters in Australia (Medium relevance). Continuous prehospital vasopressor infusions in trauma are not something most Australian ambulances run — a handful of critical-care-capable units excepted — so this informs the debate more than current practice.
Learning goal
Weigh the risks and benefits of prehospital vasopressor infusions in trauma patients before haemorrhage control.
More
- Topic: Trauma
- Daily scan: 3 October 2026
- Podcast: Paramedic Papers Daily, 3 October 2026
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