IV Dobutamine

[bluedevils83]

Hello..........can anyone give me an oversight on nursing standard of care when IV dobutamine is started??????? Does the patient have to be in CCU to receive it or can they receive IV Dobutamine while on a telemetry unit? VS protocols, titration,etc??

[Kymmi]

All depends on the hospital's protocol. Where I am at Dobutamine can be managed on a telemetry floor as long as it is not being titrated. If it is being titrated then the patient needs to be ICU with continuous cardiac monitoring. Vital signs are q 30 minutes if not being titrated however q 15 minutes if titrated. The physician will usually give you parameters to follow for titration rates. Example might be to titrate to acheive/maintain C.I. > or = to 2.2 or SBP > 90 or Map >60.

You need to watch the HR when using Dobutamine although Dobutamine doesnt have as much effect on increasing as Dopamine however it can cause PVC's to increase.

Dobutamine will increase your C.I/C.O and decrease your SVR however alot of the times those issues can be corrected simply by giving fluids.

I hope this answered some of the questions your had.

[joeyzstj, LPN]

Hello..........can anyone give me an oversight on nursing standard of care when IV dobutamine is started??????? Does the patient have to be in CCU to receive it or can they receive IV Dobutamine while on a telemetry unit? VS protocols, titration,etc??

Our facility only allows Dobutamine to be on the floors when it is a set dose and the patient is stable. They do not allow the floor nurses to titrate Dobutamine. VS are done Every two hours. We now have a stepdown unit, so they go there if possible.

[bluedevils83]

Thanks for the input..........I thought I was going crazy......sounds good!

[Ariyala]

and just fyi, try to use a central line or picc. Dobutamine infiltrations are bad bad.