Step Down Unit/Telemetry Cardiac Drips

[tanner1334]

I work on a 20 bed Step Down/Telemetry Unit. We are in the process of creating our admission/discharage criteria and also working on a cardiac drip policy. I'm trying to get some feedback on what other progressive care/tele floors use as far as cardiac drip policies. What drips do you take? Do you titrate? I appreciate any feedback.

Thank you,

[smileyRn96]

I worked on a step-down unit a few years ago, we took vents if they were stable (our call bell system would alarm if the vent alarmed) and they had to return to ICU for weaning. We did nitro, dopamine, and dobutamine gtts if they were not being titrated. We also did cardioversions with moderate sedation (versed and fentanyl).

-Smiley

[meandragonbrett]

Drips: Cardizem, DoBUTAmine, DOPAmine

No titration

No vents

[chocokitten]

I am new to my Tele floor, but I know we do Nitro drips (titrate) up to 100meqs we do not accept insulin drips, and I think we allow amiodorone drips.

[Medic2RN, BSN, RN, EMT-P]

I've titrated Dopamine, Insulin, Cardizem, and Nitro. We also receive stable vent patients. We have a 4:1 ratio.

[ckc6977]

On our floor we are able to titrate: NTG, Insulin, Dopamine, Cardizem, Amiodarone gtts. Also, do you care about Integrillin, ReoPro, Heparin gtts? (If so, we do those too).

[Spatialized]

I'm on a cardiac tele/PCU floor here's our drips:

Titrated:

Diltiazem, up to 15mg/hr

Nitroglycerin, up to 50mcg/min

Lasix, can titrate to UOP

Insulin

Set doses:

Amiodarone, per protocol

Dopamine

Dobutamine

Milrinone

Natrecor

Esmolol

Metoprolol

Lidocaine

All of these are to a set level, and based on set doses, no titration.

Of course there is heparin, Integrilin, Reopro and on...

We also do cardioversions with and with out anesthesia in room (nurses will/can handle conscious sedation), depends on doc preference. And sheath pulls. No vents...yet. Oh yeah, did I mention it can be 5:1 at night? Great fun when you have multiple drips going!

Cheers,

Tom