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Epi drip


akroeze

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exercise for those not in medic school, yet, anyone want to go through calculating and setting up doses for epi and dopamine? NO ONE here uses them (they say b/c of the math)...and I never want that limit me...

I just caught this....all I can say is.....WTF :shock:

This is embarrassing, to say the least...

-just sayin'

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For an epinephrine infusion:

1 mg/250 mL = 4mcg/mL

Run through 60 drop tubing at 2-20 mcg/min

Dopamine is a bit more complex, but not overly difficult.

400 mg/250 mL = 1600 mcg/mL

With this concentration and using 60 gtt tubing you will have a constant 26.67 mcg/gtt

Find the patient weight in kg.

Run the infusion at 2.5-20 mcg/kg/min

OR...

Use 10% of the pt weight in pounds to figure a 5 mcg/kg/min dose and titrate from there.

I hope I've gotten those right since it has been a while since I've had to think about them. :D

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Math at 0300 can be challenging. When I do the rig check, I make sure there is a dopamine drip chart elastic banded around the dopamine... and I'm pretty good at math. :D

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  • 7 years later...

I am re-writing our protocol for cardiogenic shock. Our medical director wants me to include Dobutamine (preload), Dopamine (afterload) and Epi drip for use of an increased vasopressor, and for bradycardia.

 

R/r 911

I'd ask him/her to consider a true alpha agonist to augment your epinephrine in cardiogenic shock. Epi and something like phenylephrine covers contractility and vasomotor tone very well. Dobutamine improves cardiac output thru enhanced contractility, but does risk hypotension via mild beta 2 agonism. That would be hard to tease out in the pre-hospital setting IMO. If the heart needs unloading, I'd prefer something like NTG if tolerable.

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