Critical drips

Specialties Cardiac

Published

On cardiovascular floor, which is always busy. Well we got an email the other day stating that day we started to take ketamine drips, along with our insulin, levophed and amino/cardiazem,heparin also. We've had no education whatsoever on this, got handed a sheet of paper with directions about the ketamine drip, remind you we all have 4-5 pts. Day 1 open hearts, fresh cath lab pt with sheath pulls, COPD pt on bipap's.

I feel this is dangerous and getting way out of hand. Yes, ICU uses this but they have 1-2 pts with big glass windows they can still the pt when sitting out at the pod....we can't. I just hope no of use lose our license or hurt a pt.

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Specializes in Neuro ICU and Med Surg.

I know on our tele floor they can take amiodarone, and cardizem dirps. NO levo or ketamine. Sounds a little risky to run levo in a tele unit. I can understand stable dopamine or dobutamine drips, but not levo or ketamine. All our units take heparin drips. Our tele unit does not take insulin drips either.

This seems a bit much for a unit where nurses have 4-5 patients each with ketamine and levo. Do you take stable vents in your unit?

Sounds like your not getting much education about this either. What did your manager say?

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Specializes in Mechanical Circulatory Support.

Ketamine isn't as scary as it sounds. I know our facility has a lower max dose on the floors compared to the ICU and it can really help with pain control (amio, cardizem, heparin all fair game on the floors here.). Levo and insulin gtts out of the ICU makes me raise an eyebrow though... interesting.

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Specializes in ICU.

Are you titrating these drips? but regardless, i would think That it is not safe with 4 patients. And why would ketamine be on a cardiac floor? Maybe i am missing something... Would be great if somebody could answer it. But what i know about ketamine is here

http://anesthesiageneral.com/ketamine-cardiovascular-effects/

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Specializes in Critical Care.
Ketamine isn't as scary as it sounds. I know our facility has a lower max dose on the floors compared to the ICU and it can really help with pain control (amio cardizem, heparin all fair game on the floors here.). Levo and insulin gtts out of the ICU makes me raise an eyebrow though... interesting.[/quote']

All of our floors take insulin drips, up to an 1:8 ratio.

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Specializes in Critical Care.

Personally I'd rather have 5 patients all on ketamine drips compared to 5 patients not on ketamine drips. Ketamine has very little effect on respiratory drive, BP, or cardiac parameters. It's a dissociative, very similar to PCP except with an added quasi-paralytic effect. Patient's on low-dose ketamine, which is primarily to potentiate pain meds as well as for anxiety control tend to be much less trouble. When they come off of it however it's a different story, it's supposedly very similar to being on 'bath salts' (the stuff that makes people eat other's peoples faces).

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Specializes in ICU.
Personally I'd rather have 5 patients all on ketamine drips compared to 5 patients not on ketamine drips. Ketamine has very little effect on respiratory drive BP, or cardiac parameters. It's a dissociative, very similar to PCP except with an added quasi-paralytic effect. Patient's on low-dose ketamine, which is primarily to potentiate pain meds as well as for anxiety control tend to be much less trouble. When they come off of it however it's a different story, it's supposedly very similar to being on 'bath salts' (the stuff that makes people eat other's peoples faces).[/quote']

Did you mean low dose ketamine has little cardiac affects? Or ketamine in general has little cardiac effects?

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