200mcg/min Epi...New or old dosing?

Specialties Critical

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I am a paramedic for a rural 911 EMS service. We are a county based service and have a small hospital with an ICU. They stabilize many patients, from sepsis to post cardiac arrest. We transport these patients to other facilities that are at a minimum of an hour away. They have multiple drips, blood, plasma and we mix and start drips in route if needed. I recently transported a post cardiac arrest that was on dobutamine and an epinephrine infusion of 200mcg/min. This is the first epi drip of this dose I have dealt with. Is this an old dosing or new dosing regiment?

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Specializes in ICU.

That doesn't sound correct. Typical rates are 1-4 mcg/min

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Specializes in CVICU.

Depends on the concentration in the bag. I know in the open heart unit I work in we run our gtts at 0.025-0.05 mcg/kg/min

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Neither old or new but not unheard of.

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It didn't sound right to me. It was a 2mg/5ml concentration running at 30ml/hr. 2mg/500ml at 30ml/hr or 2mg/5ml at 3ml/hr is with in normal dosing range that I am familiar with. I think some one made a big mistake.

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It didn't sound right to me. It was a 2mg/5ml concentration running at 30ml/hr. 2mg/500ml at 30ml/hr or 2mg/5ml at 3ml/hr is with in normal dosing range that I am familiar with. I think some one made a big mistake.

That mix doesn't even make sense. That is extremely concentrated! But regardless of the concentration....yes, I have seen epi gtts running at extreme dosing.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
It didn't sound right to me. It was a 2mg/5ml concentration running at 30ml/hr. 2mg/500ml at 30ml/hr or 2mg/5ml at 3ml/hr is with in normal dosing range that I am familiar with. I think some one made a big mistake.

What? If the syringe is only 5ml and is going at 30 ml/hr you are changing the syringe 6 times an hour something isn't right......

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Specializes in CVICU.

What? If the syringe is only 5ml and is going at 30 ml/hr you are changing the syringe 6 times an hour something isn't right......

You're kidding right? What he meant was that there was 2mg in a 500 bag. If you do the gtt calc you were running 2mcg/min which is normal. To run 200mcg/min you would have to infuse at 3000ml/hr. so you were doing it right some nurse just didn't know what they were doing and told you the wrong dose

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Specializes in critical care.

I am new and only familiar with epi at 1-4 mcg/min. What was the clinical picture? VS? I'd imagine if there was a dosing error of that magnitude, the patient would show signs. If they were fairly stable with that amount of drug running... could be they needed it?

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