Dopamine...quick question

Email4KH · Dec 11, 2006

Typically run as a secondary due to a rate not fast enough to keep the access patent.

mmutk, BSN, RN, EMT-I · Dec 11, 2006

I think the above statement is wrong . I would say primary as you do not need to run anything else with it.... it's not compatable with much

Creamsoda, ASN, RN · Dec 11, 2006

Whether this is right or wrong, we always run our tropes by primary infusion. Technically you shouldnt need a "drive" is what ive been told.

Cher

Email4KH · Dec 11, 2006

Even if you're hanging a low-concentrate premix of 400mg/250ml (dopamine is completely compatible with NS, dextrose, NS/dextrose combinations, and lactated Ringer's), the flow rate to provide recommended starting dosages for a 150# patient, for example, is going to be below typically-accepted KVO. If the premix is a more highly-concentrated 800-1600mg/250ml, count on sites clotting more frequently if you're not piggybacking on a KVO rate.

I'd be afraid to depend on a rate of 2 or 3 ml/hr to keep an access patent, but, if that's what your facility's policy calls for, go for it. I guess it actually goes back to the old question "how fast is KVO?" I don't trust anything under 10ml/hr (and like 20 even more!). Unless the patient is truly at risk for fluid overload, why risk the site by flirting with bare-minimum rates to keep the access patent?

Dixielee, BSN, RN · Dec 11, 2006

I prefer to run a primary bag of NS and piggyback nitrate drips into that. Then if the patient BP drops suddenly, you only have to turn off the drips and open up the saline. The same can be said for the inotropes or other drugs. If the patient has an adverse reaction, the drip can be dc'd quickly.

I feel safer having a primary bag running so if the need arises, then you still have your primary line available quickly.

AM-RN · Dec 15, 2006

In my ER we use dopamine a lot for hypotension (not low dose to improve renal fnx) and so usually pt is getting a hefty NS bolus. I generally like to piggyback my dopamine to NS (even if it's just KVO) because my dopamine drip is usually a low ml/hr.