nrs_grl
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We have this problem a lot in our ICU. It's too bad that we as the nurses many times gets stuck in the middle. I would love to have one ICU dr to be able to answer too. Another problem we have is residents treating patients in the ICU. I think every ICU patient needs a critical care consult!!!
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Our ICU pharmacist ( who is absolutely wonderful and know everything ) has had this discussion quite a bit with us. There is really no "max" dose of levophed, but if a person is septic they will more likely respond to vasopression.
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If you are infusing blood slowly you do not need the level one. The level one is only used when blood products need to be administered quickly. You are correct about changing tubing after 4 units if administering blood traditionally. However the tubing on the level one is good for 4 hrs and I have used it for about that long with a trauma victim one day. But the other response is correct, if someone is bleeding that bad they need to go to OR ASAP.