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Discussion

GI cocktail

I'm a new grad working on a step-down unit, and we recently had a patient who had an active MI while he was with us. During the RRT, the charge nurse had me call the pharmacy for a stat GI cocktail, with Mylanta and viscous lidocaine. I'd never heard of such a thing, and after I got it, I had to go help another patient, so I didn't get to see its effects. I looked it up and saw that it's intended to get rid of GI pain, but what is the purpose? To eliminate GI pain so that you know more clearly that they are actually having a cardiac issue? He was on tele and had a stat EKG, so wouldn't that verify an MI even with GI pain?

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    Yes. That's the exact purpose of the GI cocktail.

    It will take down any GI related pain and help differentiate the location of the pain (cardiac vs GI)

    It's gross. If you ever give one to your pt again, tell them to just drink it without looking or smelling.

    Kudos to you for looking it up when you got a chance!

    Now. What makes you think his pain was an active MI?

    Ekgs changes or just CP?

    If the pt was having a STEMI, we wouldn't have anyone to give them anything by mouth(maybe an asa).

    You would do MONA and activate the cath lab. So they must have been on the fence about his symptoms/ekgs0 findings/vs...etc...

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    So many pts come in with "chest pain" soon after they eat. Many times relieved with or without any cardiac or GI intervention at all. Yet most likely they'll still go for stress tests just to be sure.

    Also, if troponins are trending up, no one I know would schedule them for a stress so it's to the cath lab for them, emergently if nothing will relieve the CP.

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    It not just about the chest pain, for MI, although it is a significant symptom. A good 12 lead, troponin levels and the best history you can extract from the patient will give a better picture. And some times its not chest pain at all. We had a woman who came in with abosolutely no chest pain, but the worst ULQ "stomach" pain. turned out to be her presentation for a MI in her RCA. It really was different! Glad she didnt get a GI cocktail.

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