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Discussion

peripheral dopamine...eek!

I was always taught that dopamine should only be infused through a central line (CVL, PICC, whatever). In every facility I've worked in previously, you had to have a specific order to give it peripherally. At the hospital where I am currently a traveler on a cardiac floor this is apparently not so. I came in one night to an order to start a dopamine drip on a patient who had *only* a peripheral line. I was very uncomfortable with this and questioned it. I was told (rather disapprovingly) "We do this all the time." Since then I have seen that indeed they do. I am still really uncomfortable with it. Amiodarone is also infused peripherally here.

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We really do, do it all the time.

Scary, but true. Make sure there's regitine in the Pyxis and keep a good eye on the site!

PS I received amiodarone peripherally once. It was kinda an emergency, no time to put a central line. No ill effects.

Do it all the time in the ER; of course I wouldn't run it into a little 22 in the hand, but have given it through an 18 or 20 in the AC many, many times and have never had a problem.

at our hospital i believe the policy is that a cvl must be placed within 12 hours of starting a vasoactive medication (dopa, neo, etc) that way if someone is posibly just needing short term help they won't necessarily be put through having a cvl placed. That being said, usually we push for one to be put in asap. We usually run amio through peripherals without a problem.

If I have this runing into a PIV - I check for blood return almost constantly - when I have no blood return, I get a new line.

I was always taught that dopamine should only be infused through a central line (CVL, PICC, whatever)... Amiodarone is also infused peripherally here.

We infuse these drugs peripherally all the time.

Do it frequently. I just had a lady last night on Dopamine with "old lady" veins. She was an ICU hold in the ED. She had a 22G and a 24G. ED doc wouldn't put in a central ("she's not my patient anymore") and the admitting wouldn't come in at 2300 on a Saturday night. So she got Dopamine through a peripheral line---which was CLOSELY monitored. Also she people on pressors with no A-line....gasp:eek: Not perfect, but we do what has to be done.

on our med surg floor we run dopamine for renal perfusion thru peripheral iv lines all the time. usually these pt's don't have great veins and or code 3 and cannot go to tele for monitoring. our surgeons aren't very happy to get called in to place cvp lines.

Our hospital policy states good for 24 hours then HAS to be run through central.

I don't think we have a specific policy regarding this issue, however if it is approaching the 24 hr mark, we start waving central line kits in front of the docs' faces. I guess if it is an emergency, however, and no central access, then one has to weigh the risks and benefits of "right here, right now, this is what I have to work with."

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