Epinephrine Drips

Specialties MICU

Published

OK, our low intensity community hospital ICU has acquired its first group of Intensivists. Suddenly we're becoming more intense. Which is a good thing!! However, we're doing things we've never done before. Such as using epinephrine drips (actually, I think we used them YEARS ago but in the 4+ years I've been in this ICU we've never used epi drips).

Can anyone point in me in the direction of a drip chart or how epi drips are commonly mixed? Usual dosages, etc.? Is it the 1:1000 concentration or the 1:10,000 concentration? I haven't successfully found anything on a general internet search.

Any info you can give me is appreciated!

Specializes in ICU.

Thank- you Xigris that is it exaclty. :kiss:

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Originally posted by gwenith

We rarely if ever give 200 mcg/min of "neo" BTW what is neo??? Pharmacy does not make up our bags - we do.

If we were pushed we would use a bigger bag - same concentration.

"Neo" is neosynephrine, a pure alpha agonist which we use to support blood pressure etc.

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Like rstewart said, neo is neosynephrine aka phenylephrine .... 200mcg/min is pretty much maxed out....

We change the concentration because then there is less unneccessary fluid being dumped in.

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Specializes in ICU.

Had to look it up we do not use it here or at least I have never used it. Often our drugs have different generic names so it does get confusing at times.

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Specializes in ICU, Agency, Travel, Pediatric Home Care, LTAC, Su.

Just a thought, but why not make some reference cards with drips, be they pressors, paralytics, sedation, etc. and keep them with you.

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Interesting the variations of using that same drug across the world, I find...

I am a freelance ICU nurse working in London and and, even in one city there is no one specific guideline on mixing and administration!

Generally, I have found (through my own experience only) that the most regularly used mix was 4mg of 1:1000 into a total of 100mls of 5% dextrose and titrate for effect against weight.

Generally, I have also found that it helps with a slightly stronger solution than those I have seen posted because you are not overloading fluid-sensitive aptiens and you are not chasing your own tail to keep changing the bags on your pump!

Like I say, just mine own observations as a jobbing ICU nurse...

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Specializes in Step down, ICU, ER, PACU, Amb. Surg.

For a very neat little pocket reference with a calculator included as well as info on burns, drip rates, arrhythmias, pacers, vcents and such, got to: http://WWW.NNCCUSA.COM. I have the Critical Care Checkmate, there is also one for the Emergency Room as well. Depending on whom you talk to, some say that the ED Checkmate is better than the Critcal Care checkmate.

Always remember though, epi,neo and norepi are very necrotic if they extravisate. They should always be run through a large bore needle into a large vein.

My reference shows a concentration of 4mcg/ml (1mg to 250ml of D5W).

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Specializes in Step down, ICU, ER, PACU, Amb. Surg.

My reference says: 4mcg/ml (1mg in 250ml of D5W). Always remember that norepi, neo and epi can cause tissue necrosis if it extravisates.

I like my little Critical Care Checkmate pocket reference. Go to: http://WWW.NNCCUSA.COM They also have an Emergency Medicine Checkmate as well. Depending on whom you talk to some prefer the Emergency Med over the Critical Care.

Hope that this helps.

Christie

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Specializes in Step down, ICU, ER, PACU, Amb. Surg.

please forgive my double post. my message did not show the first time around.....good old internet lag.

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