blood and levophed in same line?

Specialties MICU

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recently i had a pt that bleed out an estimated 1000ml of blood after pulling a jp on the floor had no pulse coded her back and sent her to me with a pressure of 50/30. i started an iv and a bolus and levophed as i went down for blood, yes licensed personnel have to get blood at our hospital. when i came back IV was gone. pt started having SVT occasionally but we eventually got an iv and started the levophed. as we cont to attempt to get another line it wasnt going to happen so i called the md and he said ok we can run it in the same line ill be down there to see what we can do about a cent line.

so i did and it worked. pt did great with both levophed and blood in the same line. so i was wondering what is the exact reasoning for wanting to run these drugs with anything else like i was taught when it apparently works fine.

You had to do what you had to do. I'm glad it turned out alright this time. As others have stated... the blood can hemolyze from the osmotic pressures exerted from anything but NS. Levophed here is also mixed with D5W. However the effect in boluses might be minimal.

It sounds like you needed a central line... badly. Most patients in an ICU deserve a central line after a 1L blood loss. Frequent blood draws, boluses, pressure measurements, and stable access are a necessity. But the line wasn't placed. Then the patient coded and access was lost. Yet the line was again not placed. Then you had to resort to throwing levo and blood as fast as you can through a peripheral.

The risks were high: loss of limb, loss of life. The doc should have stepped up.

"As for extra levo might "HELP" a patient in SVT??? Are you serious? So a medication thats a positive B1 agonist, hence positive chronotrope, is going to help supra-ventricular tachycardia (heightened AV conduction rate)."

Not defending the original post or the idea that a pressor can help hypovolemia induced tachycardias but you atleast have to agree that Levophed's chronotropic effect is mild compared to other pressors such as epi or dopamine. :)

Specializes in Surgical ICU.
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Not defending the original post or the idea that a pressor can help hypovolemia induced tachycardias but you atleast have to agree that Levophed's chronotropic effect is mild compared to other pressors such as epi or dopamine. :)

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definitely agree. but with a bolus push..it cud get scary.

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