[MissERN]

Hi everyone! I was hoping you could help me out. I'm new in the ED and the other day as my shift was ending we had pt present with chest pain. I had already given report and was ready to leave, but I decided to stick around long enough to help get this pt settled. Turns out this pt has a long cardiac history and his cardiologist just happened to be in the ED. The cardiologist gave me a verbal for a "nitro drip at 10". Well, the RN who was taking the pt was there and he took over and got it started...but I haven't had a lot of experience with NTG drips and so I have some questions.

Would the order "nitro drip at 10" mean 10mcg/min, because I could have sworn that the only other NTG drip order I read was for "NTG drip at 5mls/hr". My drug book isn't a wealth of information on drips. What is a typical starting dose for a nitro drip? If anyone could throw in a calculation I would greatly appreciate it!

Thanks to all who have time to respond! I think my day off tomorrow will be spent brushing up on my calculations...especially all of the drips...they all seem to get jumbled in my head. Thanks again!

[jmgrn65]

well if only said 10 an hour that should be clarified. Having said that at our facility we always go by mls/hr others go by mcg. So if one of my cardiologists said to me nitro at 10. then i would hang it at 10ml/hr

[oMerMero]

It is best to verify the order with the doctor. It could be interpreted either way...just goes to show that the units of the med are important.

[Emmanuel Goldstein]

Originally Posted by MissERN

The cardiologist gave me a verbal for a "nitro drip at 10"...

Would the order "nitro drip at 10" mean 10mcg/min, because I could have sworn that the only other NTG drip order I read was for "NTG drip at 5mls/hr".

Perfect example of a potentially dangerous error just waiting to happen, and why hospitals have policies regarding 'read back' and clarification.

"Nitro drip at 10" is an improper, incomplete order.

[JohnW]

Don't you guys do a re-back on verbals? That would have been time to clarify. In this case, you can be pretty sure the Doc meant 10ml/hr. Depending on the concentraion you guys are using, 10ml/hr often works about to about 30mcg/min, a nice place to start your ngt at.

Personally, I think is a big mistake for places to go by mls an hr, but lots of hospitals do it.