Leah8183

I was taught to mix levophed as such: 4mg/250ml D5w and to use 8mg/250ml in central lines. The rationale was that 8mg was more of a vesicant and if extravasation occurs, it causes even more damage...tell me where I'm wrong/right.

I'm just looking for advice, tips, and guidance; just some insight. I have 8+ years of critical care experience in various ICU's. I got my TNCC, as our facility was just becoming certified as a trauma center. That being said, I observed the process of getting certified, and I've participated in a few trauma scenarios. That is the extent of my hands on experience. I live rurally, and the nearby level IV hospital has a position opening for trauma program manager. I applied because I meet all the qualifications in the job description. I am a fast learner and will retain everything I'm shown. I have great problem solving skills, communication skills, and time management skills. It seems like a major portion is auditing, process improvement, and ensuring the program is meeting regulatory standards. All these things I am capable of managing. It's new and it's exciting, but I need some perspective and honest opinions of trauma nurses.

I am interested in getting into nurse management/leadership. What advice would you give and what route of college education would you recommend? I tend to favor a master's degree in nurse leadership, but I wonder if I need to focus more on a master's degree in business with a healthcare focus. I'm interested to see what your thoughts are, as well as your experiences in the world of nursing management. My end goal is nurse executive or CNO.

Perfect explanation!

I really hesitate to hook up anything that is going fast with something that is going at a prescribed rate because I don’t want to take the risk of punching something in fast, inadvertently. In my head, everything being mixed at the Y-site would be pushed in at the pump rate that is set at a faster rate. It’s going at a higher velocity than the one being pushed at a slower rate.

Right. The pump is controlling the rate. The flow of one line is 999, while the flow of the other is 200. Once the 200 line gets into the 999 line, everything in the 999 line is, then, being pushed in at 999, from the Y site on. CalicoKitty explained this concept well

Thank you so much for y’all’s explanations! It has helped a lot! You’re right. The “secondary” or “add on” wouldn’t run out at a faster rate. I do believe that once it enters into that primary line, it’s shoved into the vein with the IVF, much like an IV push would be.

So, my title was to grab attention. ? I did encounter a nurse that thought we run a bolus at 25cc/hr, though, so it’s not a complete lie. LOL! I get mixed answers about Y-siting into a fluid bolus. Some people think it’s OK to Y site an antibiotic into a bolus, even if it’s “below the pump”. Some say that it pushes the fluid a little faster than prescribed. I agree with the latter. The pumps are set to push the fluid at a certain rate, depending on the dosage/med, etc. Boluses run at 999mL/hr. For certain Antibiotics, it’s 200cc/hr. The pump is programmed to push that antibiotic through that line at 200cc/hr, so that’s the rate of that IV tubing. The pump is pushing the bolus at 999cc/hr, so, now connecting the lines, the Abx line running at 200cc/hr is now connected to tubing that has a flow of 999cc/hr. Do I I have this wrong?