lakemurray

First I apologize especially to Ntannrn. I was rude. I did not to be intimidating anyone and am sorry if I did. Down the page on the site I posted it does state for central line use only but then also says to give through a large vein. Ambiguity is not nice. The hosp I work in has about 150 beds. We have two full time picc nurses and get central lines from residents/attendings very quickly. I had to ask around when the last time a pressor was given without a line, a couple of years ago a resident wanted to run dopamine and the rn refused to do it without a line, the short story is that the patient got the line and we get them very fast now (the patient was ok). I realize that what is done is not always what should be done and you do the best you can with what you have. For those of you who do not get lines maybe you should start an initiative at your hosp. to get more of them. We get them because they are cost effective. I originally was attracted to this thread because because we are taking lidocaine off our crash carts and one of my managers asked me if I thought levo would be a good replacement. I told her no because I was sure someone would try and start it up before their was a line in place. We do not keep levo on the crash carts. I am sorry if I took this thread away from the original subject. I won't talk about the line thing anymore. As I recall about three or four years ago there was a good article on sepsis in the critical care journal and I think it explained the use of levophed.

Apparently you cannot read. I even posted the web link. Levo requires a central line. Also where do you people work at that you give vasoconstictors without central lines? In the er while waiting for a line maybe, but not on a unit. I have not worked in a unit where we put any vasoconstricter without a central line for at least five years. Think about it. If its not going in (extravasating) whats it doing for you patients blood pressure. That sad nonsense about your wife going to die but we can't use a vasoconstrictor peripherally is nonsense. The first thing your going to do is a fluid challenge and while that is going on you get a central line placed.

If you go to Merck's drug site it will say that levo should be given through a large vein and must be given through a central line. http://www.merck.com/mmpe/print/lexicomp/norepinephrine.html look for I.V. administration. Your hospital should have a policy about drug administration. Every hospital I have been to has had a policy about administering vasoconstrictive drugs through a central line. Extravasation will cause necrosis. That being said it looks like you are a new nurse and you probably do not want to make too many waves.

You cannot use neo peripherally!!!!

I realize some people would disagree but this should have been reported and investigated. Maybe someone else is abusing this woman. Even the military has a policy in place that a Female caregiver. MD NP will not examine an unclothed male SM. Everytime a male takes care of a female unchaperoned he places his liberty at risk. This is not something new today. I saw it in psych 30 years ago witha female patient being restrained and accusing a male of rape. He was taken off patient care and the incident was reported to the DA's office. Certainly he was exonerated but this is not new. Every male should remember that all it takes is ONE accusation and your world can come tumbling down.