an oldie but goodie

[amoLucia]

For all us ancient ones, how about remembering an oldie - aramine IV drip!

Was watching an oldie TV channel and Dragnet, Squad 51 (can't remember the real name, but it was with firemen/paramedics Gage & Desoto) and then Emergency came on. Some snakebite pt had bottomed out and was in the ER. All nurse Dixie McCall was doing was taking a manual blood pressure, handing the docs meds (that docs administered) and making phone calls.

No specific directions; just "an aramine drip".

I got the biggest kick watching the nurses walking around in their white uniform dresses and their white heeled shoes (beige pantyhose) and wearing their caps. (I am an antique nurse who loves nursing caps!).

So for you all you nurses out there, what are some of the obscure and oft forgotten meds that we all used to use at some time can you name???

Aramine precipitated this thread, but I also offer that oldie, aldomet. Any others???

[WoosahRN, MSN, RN]

We used chloral hydrate for a longer acting sedative in Peds. They stopped making it a couple years ago. Man I miss that drug. Didn't need to bolus as much or increase drips.

This is a great thread. I hear from some of my coworkers how they used to have to make most of the meds themselves. Including TPN. I'm so grateful for those that paved the way. ?

[Esme12, ASN, BSN, RN]

We used chloral hydrate for a longer acting sedative in Peds. They stopped making it a couple years ago. Man I miss that drug. Didn't need to bolus as much or increase drips.

This is a great thread. I hear from some of my coworkers how they used to have to make most of the meds themselves. Including TPN. I'm so grateful for those that paved the way. 

I HATED mixing TPN...HATED IT! We had a laminar flow hood right in the ICU...you spilled ANYTHING you would stick to the floor the rest of the day.

It took us a while to "trust" someone else mixing our meds....I mean after all how did we KNOW what was really in it. LOL

[Esme12, ASN, BSN, RN]

I guess I kinda figured that but was thinking maybe there was some older monstrous looking contraption that monitored sats lol. Thanks for the info!

NO just a lot of guess work, instinct, and good assessment.

[blondy2061h, MSN, RN]

It took us a while to "trust" someone else mixing our meds....I mean after all how did we KNOW what was really in it. LOL

I wasn't working yet, but my coworkers told me years ago they had the labels swapped in pharmacy for one patient's pressor drip and anthor's beta blocker. They couldn't figure out why the more pressor they have the patient the lower her bp went.

[nurseprnRN, BSN, RN]

I was just thinking of something... How did they monitor O2 sats before pulse ox came about? I mean obviously there was blood gases but you aren't doing them around the clock, especially with neonates. Just curious if anyone knows...

Yes, actually, a lot of us do know. :) Pretty much ABGs or clinical observation and critical thinking-- VS, color, resps, effort, cap fill, general condition ...

[Ruby Vee, BSN]

I HATED mixing TPN...HATED IT! We had a laminar flow hood right in the ICU...you spilled ANYTHING you would stick to the floor the rest of the day.

It took us a while to "trust" someone else mixing our meds....I mean after all how did we KNOW what was really in it. LOL

Pharmacy used to "make" our 10cc D5W syringes we used for cardiac outputs (back in the days when we used D5W in an ice bath for COs and had to calculate the average of 3 and then the CI by long division on a paper towel). They came up in bags of 10. We also mixed our own K+ riders -- the KCl would come up in 10cc syringes (20 mEq) in bags of 10. Pharmacy mislabelled a bunch of KCl syringes as D5W, and we got them in the CCU. Imagine shooting a cardiac output -- 10cc pushed over less than 4 seconds -- and having it turn out to be 20 mEq of KCl instead of D5W. One poor lady had it happen twice -- the second time she knew what was happening. Scary!!!!

[blondy2061h, MSN, RN]

We recently added a policy that KCl goes in a buretrol. One of my first times doing it I hung 40 mEq, programmed the pump, and walked away. All the KCl went into the buretrol. I walked away and came back in the room minutes later to see just the empty bag of KCl I had *just* hung. My buretrol was hanging out of sight behind another bag. My heart stopped. Thankfully I stopped myself from panicking in front of the patient before further assessing the situation. I cannot imagine getting 60 mEq in mere minutes thinking it was d5w. What happened to those CCU patients?!?

[ausrnurse]

Pharmacy used to "make" our 10cc D5W syringes we used for cardiac outputs (back in the days when we used D5W in an ice bath for COs and had to calculate the average of 3 and then the CI by long division on a paper towel). They came up in bags of 10. We also mixed our own K+ riders -- the KCl would come up in 10cc syringes (20 mEq) in bags of 10. Pharmacy mislabelled a bunch of KCl syringes as D5W, and we got them in the CCU. Imagine shooting a cardiac output -- 10cc pushed over less than 4 seconds -- and having it turn out to be 20 mEq of KCl instead of D5W. One poor lady had it happen twice -- the second time she knew what was happening. Scary!!!!

Anaesthetics sent us an open heart with a noradrenaline syringe mislabelled as GTN once and the SBP >200. Kept turning up the GTN and the BP kept rising, eventually pulled down and replaced every single infusion.

[PMFB-RN, RN]

As a nurse who, back in the day, used to mix most of their own drips, I lament the loss of this skill among newer nurses. We used to mix our own insulin, levophed, vasopressin, and other drips right in the med room. I still do this occasionally in crashing patient emergencies. Usually get some comments from newer nurses who have always received every drip from pharmacy.

I very much sympathize with a previous poster who stated they had a hard time trusting the drips sent up from pharmacy. How can I know what's REALLY in this bag if I didn't mix it myself?

I also miss calculating my own cardiac indexes. Doing so what always very impressive to patient families. Gave them the feeling that I really knew what I was doing and that there was no need for them to spend the night, that I would take care of their loved one tonight.

[Esme12, ASN, BSN, RN]

Pharmacy used to "make" our 10cc D5W syringes we used for cardiac outputs (back in the days when we used D5W in an ice bath for COs and had to calculate the average of 3 and then the CI by long division on a paper towel). They came up in bags of 10. We also mixed our own K+ riders -- the KCl would come up in 10cc syringes (20 mEq) in bags of 10. Pharmacy mislabelled a bunch of KCl syringes as D5W, and we got them in the CCU. Imagine shooting a cardiac output -- 10cc pushed over less than 4 seconds -- and having it turn out to be 20 mEq of KCl instead of D5W. One poor lady had it happen twice -- the second time she knew what was happening. Scary!!!!

I remember the iced saline....it seemed to take 3 people to do the cardiac outputs!!!! I lived for paper towels to write on!!! We mixed everything including K...our stock med room was a pharmacy itself.

Pharmacy mislabelled a bunch of KCl syringes as D5W, and we got them in the CCU. Imagine shooting a cardiac output -- 10cc pushed over less than 4 seconds -- and having it turn out to be 20 mEq of KCl instead of D5W. One poor lady had it happen twice -- the second time she knew what was happening. Scary!!!!

Noooooo!!!!!! That actualy gave me palpitations!

I said somewhere in this thread that we were not happy when we had to stop mixing our gtts...if you didn't mix it you couldn't be sure it was what you wanted.

[nrsang97, BSN, RN]

I have mixed my own Levophed and Neosynepherine drips as recently as two years ago. I would mix the first one so we didn't have to wait for pharmacy.

[Christy1019, ASN, RN]

Can anyone find a picture of what old IV supplies looked like wayyy back in the day? I know what the glass bottles loooked like but I don't know what I'm looking for when I searched antique IV supplies, I.e. angiocaths before they had plastic ones and old IV tubing. Thanks in advance!