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Critical Care Infusion Guidelines

This document provides guidelines for infusion drugs commonly used in critical care units, including nitropresside, norepinephrine, phenylephrine, propofol, and versed. It lists the indications, how to set the infusion pumps, starting doses and titration amounts, and maximum doses for each drug. Morphine, heparin, and insulin are also mentioned as requiring double signatures when initiating or changing the infusion rates due to their risk of causing hypotension, hypoglycemia, or bleeding complications respectively.

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Mimi
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434 views1 page

Critical Care Infusion Guidelines

This document provides guidelines for infusion drugs commonly used in critical care units, including nitropresside, norepinephrine, phenylephrine, propofol, and versed. It lists the indications, how to set the infusion pumps, starting doses and titration amounts, and maximum doses for each drug. Morphine, heparin, and insulin are also mentioned as requiring double signatures when initiating or changing the infusion rates due to their risk of causing hypotension, hypoglycemia, or bleeding complications respectively.

Uploaded by

Mimi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

C0[Iil0NLYU$ED II,|FU$I0N$ in CCU

Nitropresside (Nipride) - used to deerease SBP, potent arterial vasodilator


. Set pump at mcg/kg/min
. Initiate infusion at0.2lmcgkglmin, titrate by 0.5mcg/kg/min every 10-20minutes to reduce SBP
. Max dose is l0mcg&fmin

Norepinephrine (Levophed) - used to support SBP in shock states (cardiogenic or septic shock)
. SLt infusion pump at mcg/minute
. Initiate infusion at 2 mcg/min, titrate up by 1-2 mcg/min at 10-30 min intervals until desired blood pressure effect
. Max dose is 30mcg/min.but rates as high as SOmcg/min have been reported

Phenylephrine (Neosyinephrinei- ilsed for SBP support in vasodilated ptr no effect on H&or contractility
. Set pump to run in mcg/min
. Initiate at l0mcg/min and titrate up by l0mcdmin at 10-30 min intervals
. Max dose usually 100-lS0mcgimin to increase SBP but occasionally up to 300 mcg/min
. CYORnm Pheryiephrine on sltringes in mcg/kdmin - doses range is 0.1- 4mcg/kg/min
i
Propfol (Diprivan) - used for sedation in mechanically ventilated in Critieal Care
r
Set pump to run in mcg/kg/min '
.
lnitiate atSmc{kg/min and titrate up by lOmcgkSmin at 5-10 min intervals
.
Max dose in Critical Care is usually 5U75 mcgkglminto reach desired level of sedation
'
Watch for decreases in SBP and cardiac output in higher doses

Versed - used for sedation in mechanically ventilated patients in Critical Care


.
Set pump to run in mg/kg/hr
.
Initiate at0.02 mg/kg/hour and titrate up by 0.Olm9lkg/fu every 10-15 minutes to desired sedation
.
Max dose is usually 0.2mglkglbr -
initiate at 0.5mg & titrate up by lmg every 10 min. to a usual max of 4mglhr, rarely Tmglhr
:
:-Goal RASS 0 to -3. Patient is assessed daily for wakefulness:

!t :t !t !t *!i*'t *DrUgS that reqUife DOUble SignatUres *'t !*'t !t t !t !t*

Morphine / Dilaudid PCA or Infusion - used for pain control, dyspnea in Pulm Edema & comfort care in terminally
ill pts
.Infusion bagslPCA /Epidural, Watch for hypotension, Doubki siguatures on flowsheet for initiating/changing rate
Heparin - used for prophylaxis & anticoagulation therapy for PE, DVT, AFib, ACS
' Units / hr , Check Bag I 2 concentrations in house - use 25,000 units/500m1s, Double signatures on flow sheet for
initiating or changing rate
Insulin - used in diabetic ketoacidosis, EHNS, Hyperkalemia
' Units / hr, Double signatures on flow sheet for initiating or changing rate

3 -20 13 dhawkins-wdugan

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