Titrating and weaning pressors do you follow the same order ?


Preparers for inspection came in called the nurses cowboys ,because we are titrating are drips to pt response . Inform us we must have an order by a physican for titration ok? Orders for titration are usally standard but how do you wean? I was told by the powers to be to wean pressors by the original order . I feel weaning is different than titration we must go a lot slower and reduce rates to pt response. If i jump in and decreased levophed 2.5 mcg/min every 15 min than we could have a dead pt. Should we have separate weaning orders ? I was told nursing judgement is not allowed any more must follow an order to every specific detail so how do you wean pressors to pt response and be in the graces of following standards.?


389 Posts

Specializes in ICU, trauma.

Our orders will have perimeters for an order such as keep systolic over 100 or map over 65 and to ween accordingly.

blondy2061h, MSN, RN

1 Article; 4,094 Posts

Specializes in Oncology. Has 15 years experience.

Our pressor orders usually have what they want the response to be (i.e., MAP 65), and the max rate, and that's it. They don't say how often to adjust or by how much.

Specializes in Critical Care. Has 8 years experience.

Like others have mentioned physicians must write an order as to what parameter we are to titrate vasopressors. For example: Norepinephrine 4mg/250ml, titrate to MAP of 65mmHg, max dose 30mcg. You do not need a separate weaning order or parameter. If you have Norepi at 2 mcg and observe the MAP remaining at 70mmHg then you would obviously put the gtt on hold and see if they tolerate it, you are "titrating to MAP of 65mmHg".

Specializes in ICU.

That is so stupid. As long as you have a MAP goal, and low and high drip parameters, that's good enough.

I doubt those idiots would be ranting that you had to follow specific titration orders if it was their family member in the bed.