Levophed Bolus - page 2
by Flyboy17 6,245 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
- 0Nov 21, '11 by Esme12 Senior ModeratorQuote from detroitdanoWith 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......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!
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....
- 1Dec 7, '11 by BelgianRNIn 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.