Critical care drips

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Hey all,

I spent the past 7 months on a med-surg/telemetry floor. The most complicated drip I hung was dopamine and since we can only run that at a max of 5 mcg/kg/min it wasn't something that was a huge deal. But, now I'm in the ER which I'm super excited about but also kind of intimidated by the acuity of the patients. I've done some pretty hardcore research about critical care drips but everything I've found is very extensive and in-depth. I'm really just looking for something basic I can use as a quick reference so I don't feel so in over my head. Something that has indications, contraindications, side effects, special considerations in renal and hepatic patients and half-life would be a fantastic reference. On the bright side, there's only so many drips that are indicated for certain problems. Such as, if a pt is hypotensive and tachycardic dopamine is out of the question and you're only left with a few options. The adrenergic receptors also confuse me sometimes such as what works on what receptor. Also, I struggle some with calculating mcg/kg/min to ml/min. Anyone have any good references to share? Thanks so much! :)

Specializes in ICU & LTAC as RN. FNP.

Here is how I did it. I had my somewhat old, but still useable scientific calculator. I programmed the formulas for the most commonly used drugs into it. When I needed to quickly calculate a drip, I simply had to enter things like weight, concentration, etc and it quickly gave the answer. So, once the formula was programmed when I ran the equation, it asked me to input the actual numbers for the variables of the formula. Ex, variable X could be patient weight in kg. Variable Y could be drug concentration per ml. I think my ipad has more convenient calculators now though. Also, I highly recommend you order the Tarascon Pocket Pharmacopia (sp?). Look online, about 12 or so dollars and very useful for ER or ICU. It fits in your shirt pocket, and is a quick reference for alot of drugs plus some formulas.

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Specializes in Cath Lab/ ICU.
Get yourself a Cathy White book. It is THE quick ICU (including drips) reference book. It is small in size and made durable enough to survive being hauled around in your bag or pocket. It has a great quick reference section with tabs that allow to to flip directly to whatever drug you need to know about. Has starting rates, how to titrate and the basics of mechanism of action and interactions with other drugs.

The Cathy White book is given to all of our ICU and ER nurse residents at my hospital.

Also available on iTunes for an iTouch or iPhone...

That's one nice gift your hospital gives out!

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Makes it easier if u have a basic understanding of inotrope, Chronotrope, preload, and afterload, and then you can place your drips in those categories to get a mental picture.

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Specializes in ED/trauma.

I like this guide for drips:

http://www.amazon.com/Emergency-Critical-Care-Pocket-Guide/dp/189049528X

Also, never forget your trusty pharmacist. That's what they're there for! :yeah:

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Also available on iTunes for an iTouch or iPhone...

That's one nice gift your hospital gives out!

*** Graduates also get a Litman's Cardiology III stethascope when they finish the residency. The get full pay and benifts while in the residency. Only ADN grads accepted for the SICU. BSN, ADN & direct entry masters grads welcome to apply for PICU, NICU, MICU, PACU & ER. Competition is stiff for spots in the program.

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Hey all,

I spent the past 7 months on a med-surg/telemetry floor. The most complicated drip I hung was dopamine and since we can only run that at a max of 5 mcg/kg/min it wasn't something that was a huge deal. But, now I'm in the ER which I'm super excited about but also kind of intimidated by the acuity of the patients. I've done some pretty hardcore research about critical care drips but everything I've found is very extensive and in-depth. I'm really just looking for something basic I can use as a quick reference so I don't feel so in over my head. Something that has indications, contraindications, side effects, special considerations in renal and hepatic patients and half-life would be a fantastic reference. On the bright side, there's only so many drips that are indicated for certain problems. Such as, if a pt is hypotensive and tachycardic dopamine is out of the question and you're only left with a few options. The adrenergic receptors also confuse me sometimes such as what works on what receptor. Also, I struggle some with calculating mcg/kg/min to ml/min. Anyone have any good references to share? Thanks so much! :)

For your calculations, here's a site I found to check u on your work so you can ensure you're getting the right answer:

http://www.manuelsweb.com/mcgkgmin.htm

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Specializes in Cath Lab/ ICU.
*** Graduates also get a Litman's Cardiology III stethascope when they finish the residency. The get full pay and benifts while in the residency. Only ADN grads accepted for the SICU. BSN, ADN & direct entry masters grads welcome to apply for PICU, NICU, MICU, PACU & ER. Competition is stiff for spots in the program.

Wow!! Fantastic!

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Specializes in Emergency, Internal Medicine, Sports Med.
I'm looking for a quick reference for critical drips that I can use in the ER.

I can vouch for the Fast Facts book by Kathy White. Awesome little reference binder. Just be careful no one steals it. :mad::rolleyes:

As far as conversions go, practice, practice, practice. It's not bad when you're used to it. And this is coming from someone who hates math. :)

There is a smaller book "math for nurses" (probably a million like it also) that can help you. Also in the Kathy White book it goes over drug calcs.

FYI...... I would recommend memorizing which meds are compatible with what, so when you do wind up with a sickie patient, you know that on your proximal port you can run ____, _____ and _____, medial you can run ____ and _____, distal can be used for _____ (or we use distal for cvp monitoring). You could look it all up but it would save you time.

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Specializes in Family Practice, Mental Health.

Here's a little down and dirty website for common critical care infusions:

http://www.workplacenurses.com/id69.html

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Specializes in ER, ICU.
FYI...... I would recommend memorizing which meds are compatible with what, so when you do wind up with a sickie patient, you know that on your proximal port you can run ____, _____ and _____, medial you can run ____ and _____, distal can be used for _____ (or we use distal for cvp monitoring). You could look it all up but it would save you time.
This can also be found on Micromedex with the Tressel's IV compatibility. I use that for IM meds as well to see if they can be mixed for a single inj. Micromedex is a great help... :)
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Specializes in ER / ICU.

Thanks so much! Some of those sites were exactly what I was looking for. I'm also going to check out those books.

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Specializes in Med Surg/Tele/ER.

I made a reference book for myself. I made copies of all the reference drip sheets we have, and then made my own for others. I also did my calc, how to mix, action, compatibility...you get the picture. I put them in the plastic sheet protectors with tabs on each one in a three ring binder. When I need to know about a drug I just flip to that page, and there I have all my info. I add new ones as needed.....we start a lot of drips in my ER!! If you are having trouble with your calculations why not do an example, put it in the front of your book.....then when you need it you can just plug in your numbers......My book is very popular! :)

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