New to CVSICU...cardiac gtts

Specialties CCU

Published

Hi everyone! I am a new nurse in the CVSICU. Just completed my first week of orientation and wow there's alot to learn!! I was wondering if anyone had any advice on learning the cardiac gtts. Especially in regards to titrating which makes me nervous. Any study tips?

Thanks for your help!

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Specializes in Cardiac, Transplant, Vascular, NICU.

I am a new grad who started about 7 months ago on a cardio vascular transplant unit. My advice would be to get to know the drips you use most often and know how long it takes them to work.

For instance, if you're nervous about titrating Vasopressin, then you could bump up the drip fast because of the low blood pressure. But then your systolic pressure will be in the 200's and will continue to climb.

So in short my advice is find the drips you use most often, and know how fast they work.

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Thanks for your help! I'm trying not to feel too overwhelmed. Going to take it one day at a time but besides the gtts, there is sooooo much to learn! Very excited/nervous.

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We never titrate vasopressin....

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Specializes in ICU/CCU/CVICU.

We don't titrate vasopressin either. It's either at 0.04 units/ min or off.

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Specializes in Cardiac, Transplant, Vascular, NICU.

On. My..

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Specializes in Cardiac, Transplant, Vascular, NICU.

Ok my point is still the same.

And on my unit we can titrate Vasopressin from .03 to 3.

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Ok my point is still the same.

And on my unit we can titrate Vasopressin from .03 to 3.

3? How is that possible? Y not use a different pressor?

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Titrating gtts comes with experience. It helps to learn the range for each gtt. Based on the drug range, it gives you an idea how to titrate. So if the range is small like 0-20, change the gtt by small increments, but if the range is larger like 0-300, then you might want to change the gtt by larger increments. It is also based on your facility's policy, but mostly based on patient's response to the change in drug dose. FYI: Vasopressin 0.1-0.4 for bp and max of 2 for bleeding at our facility.

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Specializes in Cardiac, Transplant, Vascular, NICU.

3? How is that possible? Y not use a different pressor?

I personally have never gone up that high. If we were up that high Im sure the pt would be on plenty other drips.

Really I was just using this as an example of titrating....

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Ithink we need to remember that every hospital, unit, physician, location in the country....all have their own feelings about which drip to use when. It is really patient, facility, and physician preference as to what to titrate and when.

Check your facilities policy and procedure manual. Know you units specific standard of care. There should be a drug book policy on your unit or computer.

The actual titration is based on patient response. You start at small increments and increase more or less rapidly depending on the patient vitals and response. What one patient may not be responding to and will need titration at 5 or 6 mcgs at a time....another patient will have rebound tachycardia and HTN with as little as 1-2 mcg.

It comes in time and experience....I know when I started out in ICCU I depended ALOT on the senior nurses (10+y) to show me the tricks of the trade...it's a shame that learning model is no longer used and the older nurses are no longer considered valuable.

Here is a good rule of thumb....http://workplacenurses.com/id69.html you might also find this site helpful...icufaqs.org

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Specializes in Cardiac, Transplant, Vascular, NICU.

Thanks for the site!

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