I'm wondering if nurses typically titrate these drips independently, or they consult with the physician for dose changes. I'm not sure about Narcan and phenobarbital.
Where I work, we are allowed to titrate these drips but it is within an order set.
It depends on how the order is written.
Usually the order will have parameters for titration. Otherwise, I'd contact pharmacy.
With specific protocols yes for Narcan (the protocol gives dose change per a scale assessment as well as criteria for consulting MD and frequency of vitals/re-assessment.)
Phenobarb in my unit really is used mostly for status epilepticus and we have no standing protocol for it so all changes are per MD.
Like Jdub6 mention, Narcan has a specific assessment that goes along with titration, we rarely use narcan as a drip.
Pentobarb we do not use often, we prefer to use Versed for our status epilepticus patients; that is titrated based on the continuous video EEG in collaboration with an epileptologist.
We titrate Nimbex, Levophen, Neo-synephrine, Fentanyl, Morphine, Ativan, etc to set parameters. Vasopressin is set at a standard .04 units and it is not titrated.
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