damanRN 654 Views
Joined: Mar 3, '10;
Posts: 7 (29% Liked)
; Likes: 9
i believe at the open house they said they accept 22-26 based on the number their clinical affiliates will allow. Also said invites sent out sept/oct.
Interview in about a week myself, interested if anyone has as well and what type of ?'s they ask.
The other day I ordered the Levo at 50mcg on a patient with a ruptured thoracic aorta... It bought us time for the family to get in... usually however, once its at 10mcg time to add a second agent and I'll stop at 20
Apparently you cannot read. I even posted the web link. Levo requires a central line. Also where do you people work at that you give vasoconstictors without central lines? In the er while waiting for a line maybe, but not on a unit. I have not worked in a unit where we put any vasoconstricter without a central line for at least five years. Think about it. If its not going in (extravasating) whats it doing for you patients blood pressure. That sad nonsense about your wife going to die but we can't use a vasoconstrictor peripherally is nonsense. The first thing your going to do is a fluid challenge and while that is going on you get a central line placed.
quoted to second your post
If your patient is about to croak you can run Levo peripherally. It's better than the alternative if you don't have a central line.
If you go to Merck's drug site it will say that levo should be given through a large vein and must be given through a central line. http://www.merck.com/mmpe/print/lexi...inephrine.html look for I.V. administration. Your hospital should have a policy about drug administration. Every hospital I have been to has had a policy about administering vasoconstrictive drugs through a central line. Extravasation will cause necrosis. That being said it looks like you are a new nurse and you probably do not want to make too many waves.
Never Levo Peripherally - ever. where I am but we DO use Neosynepherine peripherally. The low dose and usually for a very short amount of time. Usually our surgical patients get a "spash" for a little while. Or while we wait for out lovely residents to put in a central line.
It just blows me away to read what nurses are writing here.. 100mcg + of Levoped is really negligent practice no matter what a doctor tells you.. you have nothing to back you up... sometimes perhaps the tank is empty so no matter how much you squeeze it you are not going to get an adequate BP.. perhaps an inotrope is needed etc.. giving super high dose pressors has been proven to be detrimental to patient outcomes... in our unit 30mcg is the max .. a good clinican is more comprehensive in approach than just titrating up and up and up.. furthermore MAP should be used as guidance for titration and not SBP..... im dissapointed in this age of evidenced based practice and patient safety that nurses would go along with this.... NOT in my unit !
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