I am an east coast Paramedic working my way through nursing school
in my local ER. I perform Critical Care Transports. I want to gain valuable experience prior to taking on the responsibility of being an RN.
During my skills assessment and oral boards I was given a scenario by the Medical Director that has be somewhat puzzled. My pt was in severe respiratory distress secondary to acute pulmonary edema. The patient's meds included hydrochlorothiazide as the diuretic. We only carry Lasix on the truck. The Medical Director asked me my treatment of the patient. I gave him the standard protocol answers of O2, IV, EKG, NTG...but when it came to diuresis I was a bit stuck. Even though I know what hydrochlorothiazide was...I didn't know if there was a conversion type dose vice standard dose of Lasix. I was honest and stated that while I wasn't sure I would call the on duty MICN or MD. He liked that answer...but still wanted an answer if 'push' (pun intended) came to shove. I gave him the dose of 40mg-80mg Lasix..erring on the side of the lower dose.
I have not been able to corner the Medical Director since being hired to find the correct dosing. Doc's can be somewhat busy in the ER. LOL! I have researched the Internet to see if there is some sort of conversion factor. I have some understanding of how each works for diuresis. Would someone enlighten me?