Does anyone use it?
Weingart says its bad and that there is really no use for it as there are superior alternatives.
Agree?
Weingart says its bad and that there is really no use for it as there are superior alternatives.
Agree?
Does anyone use it?
Weingart says its bad and that there is really no use for it as there are superior alternatives.
Agree?
Is dopamine being safer peripherally even true or just antiquated dogma?
Is dopamine being safer peripherally even true or just antiquated dogma?
Give me a "dirty epi" drip any day. 1 mg in a liter of NS. Each 1 ml = 1 mcg epi (0.001mg).
I use it all the time as a push dose pressor as well. I have the nurse mix it up, then I pull off 20 cc at a time. Pushing it slowly, even after 20 cc, all you're giving is 0.02mg (20mcg) of epi... tiny doses. But it works wonders in things like anaphylaxis and borderline stable bradycardia. And you can just keep pushing 20mcg doses until you get the effect you want.
For the patient who is just ill and needs a pressor, "dirty epi drip" in a 1 liter bag and hang it open over an hour. Makes it easy. Let the drip calculations to the ICU folks upstairs.
That's like one of those "if a tree falls in a forest..." questions. It doesn't matter if it's true if its accepted as dogma and your staff are uncomfortable doing it because it's against their protocols. Sure, you can fight to change things, educate your staff, get in on the pharm/med safety committee, negotiate with nursing leadership... But is this THE fight you want to spend your energy on? The answer is a definite NO for me.
I can McGuyver an epi drip too. But I need dopamine when I don't have time to place a central line right now because a bunch of other things are happening in the ED. If I don't have time for a central line, I don't really have time to mix/hang/pump/check the epi drip either. I do have time to say "hang the dopa".
I have seen some research of late that levophed and epi can safely be administered through a PIV as long as the nurse does IV checks every hour. I was thinking about how to sign that out to the ICU
Step 1: Tell them you are running levophed through a peripheral IV, but it's ok because you read some research.
Step 2: Place phone 2 ft from ear, prepare for explosion
Exactly. Again, you might be in the right, and if you consistently do this, explain yourself, share that paper on every sign out, then eventually the ICU folks may come around to it. But is that how I want to spend my energy?
I feel like each of us can have 1 issue we harp on. The particular pet peeve you are willing to fight for change over. More than one issue though and you become 'that guy'. I don't feel that the ability to run pressors through a PIV is worth it for me to make my one issue.
Thanks for all the answers!
Can soemone please tell me the argument FOR using it?