Ativan, insulin, alcohol drips on floors?

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For those of you who work in med-surg, do you do ativan, insulin, or alcohol continuous infusions on your floor? If so, how do you handle the frequency of the vitals you need to do, as well as monitor the patient (as well as your other patient load?) Any insight?

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Sorry, but I've not heard of an alcohol drip IV, can anyone enlighten me?

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Never heard of these (ativan and ETOH) going in IVPB.

Insulin, that one I've seen. Never seen it on med/surg floor though. ICU only.

"That's my story, and I'm stickin to it."

ken :devil:

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Specializes in Trauma acute surgery, surgical ICU, PACU.

ETOH infusion only given in step-down (2 pt's per nurse, 4 when someone is on break). Vitals q4h routinely in SDU, more often if pt's condition warrants. Nurse always in the room.

Insulin IV continuous infusion is routine on our ward (lots of pancreatitis). (6-7 pt's per nurse) Blood Glucose checks q4h and if pt is symptomatic. We are given a sliding scale order to adjust the rate of insulin infusion according to what the glucose reading is. There is a resident in-house 24/7 to address emergencies as well, so we do have a lot of support.

Never seen ativan infusion...

Susanmary, what is the situation where you are? More patients than what we have here? Why is it unsafe?

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Specializes in Trauma acute surgery, surgical ICU, PACU.

PS huganurse - ETOH infusion IV is given as the antidote to Ethanol (antifreeze) poisoning....

Also - what do you guys mean when you say "drips"?

We use syringe infusion pumps to give these meds....

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I learned a new one today. - No, I've learned more than one, but the ETOH drip has the most impact on my aged and sleep deprived brain.

Have a nice weekend!

ken :devil:

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Originally posted by pebbles

....Also - what do you guys mean when you say "drips"?

We use syringe infusion pumps to give these meds....

In the dark ages we didn't have those. Had to piggyback meds into the primary IV, and count the drips/min., then adjust with the roller clamp to control amount of medication given over prescribed amount of time.

ken :devil:

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Specializes in ICU/CCU (PCCN); Heme/Onc/BMT.

I've worked with insulin gtt (many times) and ETOH drip (once a long time ago in an MICU). Only heard of an Ativan drip. (Usually use a Versed or Propofol gtt for sedation for vent patients.) Never heard of any of these drips used on a med/surg floor.

Has anyone heard of a caffeine gtt?!?!? Worked with a patient once who was ordered a caffeine drip to help an acute migraine headache. Used it once on a "regular" medical floor.

Ted

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Specializes in Trauma acute surgery, surgical ICU, PACU.
Originally posted by 4XNURSE

In the dark ages we didn't have those. Had to piggyback meds into the primary IV, and count the drips/min., then adjust with the roller clamp to control amount of medication given over prescribed amount of time.

ken :devil:

Uh huh... :)

I hope most places don't do that now though...

Could that be what is contributing to the feeling of "unsafe"?

I set the insulin rate at 2 units/hr on the machine, I know I don't have to check it again for another hour (iv's get checked at least every hour to make sure everything is working, but less often if we are really busy)

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Originally posted by pebbles

Uh huh... :)

I hope most places don't do that now though...

Could that be what is contributing to the feeling of "unsafe"?

You betcha!

I haven't seen any of what I'd consider critical meds PBed like that in the recent past, though we still do abx that way in the ERs I've worked in. Those we mostly just use the S.W.A.G. method, and they run just slow enough not to hurt, and fast enough to clear the bed so we can get someone else in it.

just my $ .02

ken :devil:

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Forgive me pebbles.

You gotta remember, I haven't been on the "floor" in a fair number of years. Where I come from we're into that instant gratification thing. Fix it if it's broken, and get em on their way. - Home or off to the "floor".

just my $ .02

ken :devil:

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We frequently have insulin gtts on my floor--renal. BS checks q 1h, and usually have 5 other patient.

No alcohol gtts.

Have given Ativan 2mg q2h IV push with our DT precaution protocol holding for

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