1. Hi everyone! I was hoping you could help me out. I'm new in the ED and the other day as my shift was ending we had pt present with chest pain. I had already given report and was ready to leave, but I decided to stick around long enough to help get this pt settled. Turns out this pt has a long cardiac history and his cardiologist just happened to be in the ED. The cardiologist gave me a verbal for a "nitro drip at 10". Well, the RN who was taking the pt was there and he took over and got it started...but I haven't had a lot of experience with NTG drips and so I have some questions.

Would the order "nitro drip at 10" mean 10mcg/min, because I could have sworn that the only other NTG drip order I read was for "NTG drip at 5mls/hr". My drug book isn't a wealth of information on drips. What is a typical starting dose for a nitro drip? If anyone could throw in a calculation I would greatly appreciate it!

Thanks to all who have time to respond! I think my day off tomorrow will be spent brushing up on my calculations...especially all of the drips...they all seem to get jumbled in my head. Thanks again!
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Joined: Jan '04; Posts: 80; Likes: 124
ED staff; from US
Specialty: 3 year(s) of experience in ED

3. well if only said 10 an hour that should be clarified. Having said that at our facility we always go by mls/hr others go by mcg. So if one of my cardiologists said to me nitro at 10. then i would hang it at 10ml/hr
4. It is best to verify the order with the doctor. It could be interpreted either way...just goes to show that the units of the med are important.
5. Quote from MissERN
The cardiologist gave me a verbal for a "nitro drip at 10"...

Would the order "nitro drip at 10" mean 10mcg/min, because I could have sworn that the only other NTG drip order I read was for "NTG drip at 5mls/hr".
Perfect example of a potentially dangerous error just waiting to happen, and why hospitals have policies regarding 'read back' and clarification.

"Nitro drip at 10" is an improper, incomplete order.
6. Don't you guys do a re-back on verbals? That would have been time to clarify. In this case, you can be pretty sure the Doc meant 10ml/hr. Depending on the concentraion you guys are using, 10ml/hr often works about to about 30mcg/min, a nice place to start your ngt at.

Personally, I think is a big mistake for places to go by mls an hr, but lots of hospitals do it.