Most drips at once

assidere · Oct 10, 2014

First of all, to the OP, "saline" doesn't count as a drip, lol.

As far as my experience, it was an exercise in futility, trying to save a patient who over-dosed on Calcium channel blockers. Having witnessed it first hand, its an awful way to go, since in his few lucid moments between vomiting his guts out, he was beggign me to save him.

For Ca-channel blockers, we don't have a true reversal agent, like we do with narcs...

I believe it was Levo, Neo, Vaso, Dopa, Dobuta, Insulin, Glucagon, Calcium Chloride, Mag/K/Phos replacement, two misc antibiotics, and low-dose Versed.

delphine22 · Oct 13, 2014

Out of curiosity, did your pt live? If so, did they regain any useful functions?

No, they withdrew support. He never woke up after rewarming. However, his initial resuscitation took 45 minutes.

Go-GetterRN · Oct 14, 2014

Levo, vaso, neo, epi, propofol, and versed drips, then protonix, and octeotride continuous infusions. Plus 12 or 13 blood products.

Another time levo, neo, dopamine, epi, glucagon, and insulin drips with some continuous bicarb.

Ive seen a lot of studies that say when you get to the point where 2-3 pressors isnt doing the trick, there is little to no hope for that person and you are basically just giving the family time. With the exception of some major surgeries and other specific cases where you are just using them to temporarily manipulate different blood vessels.

Da_Milk_of_Amnesia, MSN · Oct 16, 2014

5+3+3+2...so 13 or 14...I forget in addition to CVVH, Swan, ECMO, Vented. And i had to manage it all by myself.

guest769224 · Oct 16, 2014

5+3+3+2...so 13 or 14...I forget in addition to CVVH, Swan, ECMO, Vented. And i had to manage it all by myself.

Isn't ECMO a mandatory 2:1 patient?

It is where I work

Here.I.Stand, BSN, RN · Oct 16, 2014

Isn't ECMO a mandatory 2:1 patient?
It is where I work

It is at my current and former hospitals, too. 1 RN or a perfusionist for the ECMO only, and 1 RN for everything else.

Da_Milk_of_Amnesia, MSN · Oct 16, 2014

Nope they were 1:1, we had a lot of people helping but once theg were on ECMO they usually stabilized for the most part, the rough part is everythjng that occurs before they get them on. Perfusion was there for any rolling or moving of the patient, otherwise they rounded q2H and I called them if I needed them. You can only adjust the sweep so much to make your gas better. They stayed at the bedside for any pediatric ECMOs, otherwise I had a bunch of clamps and a hand crank for the pump if we lost power of if something bad happend, and we one time had a oxygenator literally crack and break apart, it was bad, very very bad.

SummitRN, BSN, RN · Oct 16, 2014

12 on a post code didnt make it

icuRNmaggie, BSN, RN · Oct 19, 2014

17 pumps counting blood products. I can not remember a thing about the patient.

NPOaftermidnight, MSN, RN, NP · Oct 25, 2014

The most I've had (minus MIVF/abx, etc) at once is 10 - levo/vaso/epi/versed/fentanyl/nimbex/insulin/bicarb/heparin/TPN, on CVVH.

The patient actually lived and came walking through the unit a few months later. It was unbelievable.

APRN., DNP, RN, APRN, NP · Oct 25, 2014

13 gtts. Plus riders

Propofol

Versed

Fentanyl

Rocuronium

Phenylephrine

Levophed

Nexium

TPN

Vasopressin

Na HCO3

Regular Insulin

Amiodarone

NS with 20 K

PRBC's with Platelets and FFP

Numerous, numerous little K riders and ABX piggy backs.

Oh yes, and CRRT too.....

Running in place the entire 12 hour shift.

ktliz · Oct 26, 2014

One of my worst days on the unit--up to 16 pumps running at once, including abx, electrolytes and blood products. Four stacks of four pumps each. Patient was on CRRT so I was doing hourly Is&Os, clearing the volume on every one of those pumps every hour. Patient died that day on 30 of Levophed, 20 of epi, 50 of dopamine, 300 phenylephrine. Don't remember what the patient was on for sedation but I think it may have been fentanyl & versed. Nimbex, bicarb.... I don't remember what else.