Dopamine Guidelines

[Treen]

Our facility doesn't have a written policy for monitoring of dopamine drips. What does your policy say in terms of frequency of VS, etc?

Thanks!

[Treen]

Anyone?

[Hoozdo, ADN]

Anyone?

Anyone in my hospital that gets a dopamine drip is on monitors in the ICU. Frequency of vitals is continuous.

[Treen]

What if the patient is DNR and not on monitors?

[Hoozdo, ADN]

What if the patient is DNR and not on monitors?

Well, that would make it impossible to titrate the Dopamine. At my faciility, if he was DNR and NOT on monitors, then he would not be on Dopamine. He would be a comfort care pt and probably be on a Fentanyl drip instead of Dopamine.

[AM-RN]

From my experience, someone can be DNR and still wish to be treated with pressors. I would never ever ever ever ever initiate a dopamine gtt w/o cardiac monitor. i check bp's q 5 mins. i titrate up to acceptable bp q 5-1o mins. generally speaking...the md order should give you all the info for titrating. "dopamine 5mcg/kg/min and titrate to b/p greater than 90 systolic"

[catlady, BSN, RN]

We run dopamine on our tele floor. We aren't allowed to titrate, though; all changes have to be written by the MD. And of course, they are on tele monitors.

[KellieNurse06]

Hmmmm. My daughter is in the hospital as we speak...she was on a dopamine drip due to low b/p and on monitors and she is a dnr ...:)

[nicolel1182]

I don't work in a hospital, but wanted to give you some (((Hugs))), must be tough to see your child in the hospital!!

[KellieNurse06]

aww thanks Nicole! She is a frequent flyer so it's something we are used to unfortunately... & she's getting better thankfully!:icon_hug:

[jkw_83RN, BSN, RN]

It is extremely weird to me that a patient would be on a dopamine gtt without having to be on a cardiac monitor. First I would want to know why is the patient on dopamine, is it for renal perfusion (a low dose 1-5 mcg/kg/min) or is it for the blood pressure (dose can be anywhere from 5-15 mg/kg/min, max dose 20mcg/kg/min). I would ask the doctor for a cardiac monitor and then I would make sure that I have parameters for the dopamine gtt (to know when to call the doctor, what is the max dose, when to shut it off:idea: ). Personally, I check vital signs every 5-10 minutes when I first start the gtt, then every 15 mins until they are stable. Then I would check every 30min-1hr, depending on the situation. Since you are on a floor, maybe every hour, but if that patient is that sick and it isn't safe for you to monitor that patient on your floor, then the doctor needs to choose a different med or transfer the patient to ICU. Hope that helps.