[pebbles]

I think you did the right thing.

After all, you have to take care of the A-B-C before you do the D (which is neuro/disability), and with a low BP, your C is in jeopardy.

It should always be communicated and known why a pt is on a specific drug, ESP if it is off-label use. And if it's becoming less safe to use the drug, it needs ongoing re-evaluation.

The doc that was upset you'd turned off the diprivan - was only thinking about the one body system he's treating, and not the whole pt. Really, he should have been upset with the other doctors and not you. If the BP would have been higher, you could have turned it back on.

It's great to say that diprivan can suppress seizures. But in this case, the pt was not able to tolerate that therapy, and the treatment needed re-evaluation. (more fluid to make sure "the tank is full", colloids, etc could have made a difference as well. All of which is something that should have been managed by your on-call doctor.).

[walk6miles]

I am learning something new everyday..... question, if the order was to be for seizure control, why not use a pressor for increase/control of BP?