Just a reminder re: Diltiazem drip !

[walk6miles]

I recently followed a nurse (she is days; I am nights) I admire. We recently followed each other on the same assignment (makes report sooo easy). We discussed the difference in the patient's high heart rate which until around 1 p.m. that day had been controlled very effectively by the drug, Diltiazem. She had even been able to wean it to around 2 mg earlier in the day -down from 15 mg. Now she was chasing the rate (140's) again. We ruled out dehydration, high temperature, a change in the EKG, etc. - putting our heads together. I elected to call the physician who gave me orders for Digoxin.

Shortly after the telephone call, the pump alarmed low volume and I removed the Advantage NS bag and the Diltiazem bottle from Pyxis. Simple! pull off the two tops, screw the two together and pop the rubber plug - shake until mixed and hang. As I closed in on the empty set on the pump, it became obvious what the cause of the problem was: the plug between the drug and the NS was not popped.

I had to call the Doctor to let him know (he was surprisingly nice) so he gave me parameters for the Dig. Happily, within an hour the rate was controlled once again.

Hope our experience helps (keep it in your checkoff list)!!

[UM Review RN, ASN, RN]

Thanks for the info.

I'll put this in the "stuff happens" category and keep it in mind when dealing with those newfangled types of dosing units.

[seanpdent, ADN, BSN, MSN, APRN, NP]

It's a hard lesson learned by everyone. Check, check and recheck everything.. no matter who you work with and/or follow. We are all human.