💡 Wrong Vasopressor = Worse Outcomes

Norepinephrine in cold shock:
Increases afterload on an already failing heart → cardiac output drops further. You squeeze vessels that are already clamped.

Epinephrine in warm shock:
Excessive inotropy without enough vasoconstriction → arrhythmia risk with persistent hypotension.

Safety rule: When the phenotype is unclear, start with epinephrine. It provides both inotropy (beta-1) and vascular support (alpha-1).