Starting PICU, need help with drips

[Kidrn911]

I am taking a PICU position, it is a level 1 trauma PICU, with alot of violence, GSW, Abuse, and MVC. No cardiac, or HEM/OC. I have worked Level 1 trauma in Peds ER for 8 years. The philosophy was stablize long enough to get to PICU or Cat scan/OR.

I honestly don't have much experience with drips and calculations. Can anyone suggest any good websites?

Also any advice of dealing with families of the gang bangers? In the ER we didn't have to deal with them for an extended time like some of you have.

[NotReady4PrimeTime, RN]

Drips and calculations aren't that difficult. You'll catch on quickly once you're more familiar with the standard concentrations used on your new unit. Dose calcs are simply the desired dose divided by the available concentration. For example, you need 17 mg of IV pantoprazole. The vial contains 40 mg and the recommended reconstitution is with 10 mL normal saline, giving a final concentration of 4 mg/mL. The volume of drug needed is then 4.25 mL. Another example is an order for folate, 100 mcg NJ. The bottle is labeled 1mg/mL. 1 mg is 1000 mcg, so the desired volume is 0.1 mL. Make sense? For some practice you could go to http://www.pedstudent.com/?page_id=14 and check it out.

[rebelk]

Welcome to the PICU! Many of the drips you will be exposed to will be used again and again so that you are able to become familiar with their actions and normal doses/ranges/concentrations. If you are interested, we use these gtts frequently in my level I PICU:

For sedation/analgesia: Versed and Fentanyl (nearly everyone who is intubated receives this combo); Propofol and Precedex are used less frequently.

For trauma/shock pts: Dopamine and Epinephrine, Nicardipine

For Neuro/head injury: Vasopressin, 3% saline

Others: Insulin gtt

Although I can't recall any particular instances with family members as known gang members, we are a locked unit and have utilized the hospital police when necessary. I believe one of the most important functions of a PICU nurse is the ability to diffuse a tense situation with aplomb. I have always treated family members courteously, regardless of the situation. Hope this helps! Good luck!