Levophed Bolus - page 2

by Flyboy17

5,924 Views | 14 Comments

Recently during a code situation that involved a pt's RCA and V-Fib we maxed out on our Neo gtt, Epi gtt, and Levo gtt. We were then giving 3-5 minute bolus of epi and neo just keep his pressure up. I requested to the MD that we... Read More


  1. 0
    Quote from detroitdano
    I've seen a kid brady down with Levo bolus' before, like HR of 30-40 which self-resolved after about 5 minutes each time.

    Not so sure I'd be comfortable with that, but like was mentioned, when the other option is death, I guess it's worth a go!
    With children the med choices are different because the are built different as the administration of a narcotic can cause a paralysis/stiffness of the chest and make it difficult to ventilate them......

    Quick IV boluses are commonplace in the OR and are reffered to a s "giving a wiff" of xyz.....especially when removing a patient from pump. Levo is similar to epi and depending on where you are in the country is what drug is used. I worked with a group of MD's that would give epi first and we called it leave em dead levophed.....when I moved to another state they about had a stroke when I mentioned epi....
  2. 0
    All I know is that this was a lot of Alpha to have Neo, Epi and Levo.

    Jonathan
  3. 1
    Quote from Flyboy17
    All I know is that this was a lot of Alpha to have Neo, Epi and Levo.

    Jonathan
    The patient probably doesn'/didn't have the best prognosis.
    fiveofpeep likes this.
  4. 1
    I've only seen levo boluses used here and there, but we push sticks of neo all the time for acute hypotension in patients who are either maxed on their vasoactives or while we are getting the bags mixed. Works really well in a pinch!
    fiveofpeep likes this.
  5. 1
    In our hospital we sometimes use small amounts of levophed in bolus when the situation turns dire and we are about to go into a code (32 - 64 mcg as a maximum). Sometimes it is used when switching the levo drip when we know they are very dependent to prevent an extremely low BP.

    In pedes cases we hardly ever use Levo as they are prone to reflective bradycardia when administering levo. We prefer Neo or epi in children for this reason.

    Correct me if I'm wrong but when I was still in nursing school we were thought dosages for epi and norepi were interchangeable during a code but I can't support this statement with ALS guidelines (mostly because it is 2am here and it seems like too much work).

    Anyway these were my thoughts on the matter.
    fiveofpeep likes this.


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