SPOTLESS 2- Prospective trial investigating the safety of peripheral vasopressors in pre-hospital and retrieval medicine

New Standard Operating Procedure on how to run peripheral vasopressors safely -Using peripheral Cannulae in the arms or below the knees -Must be <5cm long -Infusing Adrenaline or Noradrenaline via pump or syringe driver (B-Braun) -Treatment as felt indicated by treating retrieval clinician in liaison with retrieval co-ordinator -Duration of treatment recorded as arrival of team with patient to handover at receiving facility, so includes ground, air and any road legs to transfer. -Complications followed out to 24 hours post handover at receiving -Infusions will be run per protocol involving dedicated lines, regular line obs and guidance on site and type of canula and patency checks prior to use. Guideline based on internal audit data and literature, was an update on last 2016 guideline. It will be attached to this document and available. Due to the configuration on pumps, initial recording will be in mcg/min, audit range for this was 1-50mcg/min with medians for adrenaline and noradrenaline peripherally of around 12mcg/min. As this study includes children mcg/kg/min will also be provided in write up based on known patients weights also collected. Compliance is asked with tick box questions in the data collection page. Adverse events are investigated via internal and external governance and adherence to the guideline would be part of any investigation. Care based on updated SOP and education from retrospective study was planned to be reaudited with a new data capture page dedicated to peripheral vasopressors as specific questions related to it. This new data capture became live on 1st April 2022. Data from this prospectively collected cohort will be included in the analysis from 1st April onwards. Full ethics was received on 18/7/22 and at that stage 116 patients had already been captured