Multiple gtts

[KG MSN RN CCRN CEN, MSN, RN]

Hello all,

I am a BSN student graduating in April, and I recently accepted a job at a level one trauma center CVICU. I have been an ER tech at the same hospital for almost two years now. And right now I am doing my role transition in the neuro intensive care unit.

I guess my question is how long did it take you to get used to having multiple drips and knowing which drips need to be increased or decreased, and which drips to deal with first and things like that? In the neuro ICU, I have only had patients that had been on one drip (levo); but I have helped with others that are on sedation (propofol and fentanyl) but never dealth with those drip settings. Even when I only dealt with the levo drip, I was just really confused as to how much the drip needs to be increased or decreased, and how long do you wait before inc./dec. again, and maximum dosage. I'm not sure if it's just because this was the first drip that I have ever dealt with, but going to be taking care of multiple gtts in the CVICU has me a little (okay, very) intimidated.

Any tips, tricks, or resources that can help with drip management?

[Altra, BSN, RN]

Hopefully your order sets will include titration parameters such as frequency and increment - these are a good starting point. Management of multiple vasoactive gtts requires a solid knowledge of the drugs' pharmacology and your patient's particular patho.

Make use of all of your resources during orientation - your preceptor, other nurses, physicians, respiratory therapists, and physicians ... and your hospital's clinical references.

Enjoy the learning!

[RNNPICU, BSN, RN]

You will usually have parameters for increasing or decreasing, typically an order might state, to keep sedation at a certain level, or blood pressure MAPs within a range or even ICPs and CPPs. Also in morning or evening rounds there should be a discussion as to which should be increased or decreased first. use your preceptor, educators/instructors and care plans to also help guide your decision tree making.