Mixing epi drips

[foshizzo]

---

Members do not see this ad.

How do you mix epi drips at your programs? I've read anywhere from 1mg/250cc to 4mg/250cc. At my program they tell us to mix 4mg/250cc but it seems like a waste of those 1mg epi vials since that is 16mcg/cc, and we rarely use more then 2-5 mcg/min for less then 1-2 hours.

Also, is it necessary to put nipride in D5W? Although the books seem to indicate this, I've seen attendings mix it in NS routinely.

 

[UTSouthwestern]

How do you mix epi drips at your programs? I've read anywhere from 1mg/250cc to 4mg/250cc. At my program they tell us to mix 4mg/250cc but it seems like a waste of those 1mg epi vials since that is 16mcg/cc, and we rarely use more then 2-5 mcg/min for less then 1-2 hours.

Also, is it necessary to put nipride in D5W? Although the books seem to indicate this, I've seen attendings mix it in NS routinely.

The situation dictates what concentration of epi you will use. Do you need a stronger concentration because you might be giving high doses and don't want to be changing bags in the middle of a case? Is there (and there typically is) a volume issue where you might want to concentrate your epid drip to minimize the volume you give? Cost is an issue, but $3.74 a vial is manageable and worth the cost versus the risks such as the ones above.

Nipride should be mixed with D5W for molecular stability and prevention of reaction with trace contaminants that is more commonly found in salt solutions such as normal saline or lactated ringers.