Amio in a Code

Specialties Emergency

Published

Specializes in ED.

Documenting a code today.

Full arrest, kept going into pulseless vtach, vfib.

Drug pusher mixed the 300mg of amio to hang PB over a few minutes...... ?!?

Don't you just push this in a code situation?

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Yep, you do.

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Specializes in ED.

Thanks, Lunah.

I have pushed the Amio myself before in a code, different facility. Just wanted to check with y'all, make sure I wasn't missing something.

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Once the pt is stabilized with IV push, they start a drip to make sure the patient doesn't flip back....are you sure that isn't what they were doing? Protocol I believe is to "bolus" and then start a drip.

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Specializes in ED.
Once the pt is stabilized with IV push, they start a drip to make sure the patient doesn't flip back....are you sure that isn't what they were doing? Protocol I believe is to "bolus" and then start a drip.

oh, no. She was giving the 300mg as a IVPB.

We then did a drip.

I have given this drug several times in codes, always as an Iv push. I am at a new facility now and they are driving me batty. :uhoh3: Causing me to second guess everything i have learned......

For example: all IV infusions must be put on a pump. Even a NS bolus :eek: They expect us to do this with an insufficient amount of pumps.

A doc today ordered for me to give kayexalate and an albuterol neb to a patient who was "hyperkalemic", her K was 5.7 (3.6-5.1 is normal at our facility) AND she was being diuresed with Lasix. Where I come from, we don't treat anything less than 6, ESPECIALLY if we are diuresing them.

BUT, the ratio here is 3:1 most days during our busy hours, so I guess, in the end, I can't really complain.

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3 to 1? HEAVEN!!!!!!!!!!!!

ps was this MD a resident?? Watch out for July 1st everyone...

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Hi! Just curious - why the albuterol neb? And I agree, I would have questioned the Kayexalate with the Lasix, too . . .

Thanks!

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Maybe she was a CRF pt with some cor pulmonale going on. sluggish kidneys slow to react to the lasix? maybe MD was worried the lasix wasn't gonna pull enough off. Probably had some fluid backup in the lungs...acute exacerbation of CHF is my guess.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Albuterol lowers the K+, pushes it back into cells.

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Specializes in ED.

She did have CKD (no dialysis), and for that reason probably lives above 5.1. She had EDEMA everywhere (CHF) and used to be on lasix everyday but was taken off (dont know why). Lungs were clear.

This doc happens to be the medical director of our ED. He treats every little abnormal lab. A person with a potassium of 3.3 (normal, young, 25 year old patient) must get PO potassium. Its just a little annoying.

(Mostly its annoying because he gives you admission orders, you start to get the patient ready to go up, and he orders 5 more things. Don't get me wrong, i will always do whats right for my patients, but he is a little order happy)

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Specializes in icu/er.

yep i cant stand those nit-picky littel orders that er docs do, dont they realise they are gumming up the works..i got a doc that orders 2mg mso4 iv for everything from a h/a, backpain to help with a i&d of abcess. now i dont mind given the pain med put havin to put in a ******* iv just to have to d/c it in about 1 hr is a pain in the orifice after about 10 per day! whenever the doc from uab is on the schedule we always stock the iv trays well.

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Specializes in Surgery, Tele, OB, Peds,ED-True Float RN.

Nope, we put it in a mini bag and run it over 10 min.

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