Advice When Pressed

Anticipating problems is something nurses can get really good at.  If you walk into your patient's room and see this:

The first thing you should ask the nurse giving you report is "Are there back up bags of levophed and phenylepherine and vasopressin in the 'fridge?"

If you forget to do this, don't worry--you'll only forget it once. 

Here is an exact time sequence one what happens when a pressor runs out.

First, the pump alarms, telling the nurse that the bag is empty.  A yellow alarm starts.

The nurse will feel a sudden clench in her bowels.  She sprints madly down the hall, ignoring other distractions.

At this point, time goes into slow motion.  The nurse gets to the med room and tries to remember the code to the door.  A red alarm is going off loudly.

There's a long line in front of the Medispense machine.

The nurse rips open the refrigerator door and stares at the patient's med bin in a futile hope

Seeing it's empty, the nurse shoves other staff out of the way

Grabs the phone, dials pharmacy

Abandoning that, shoves her way to the front of the line

Struggles to remember her most recent password

Pulls the drug and the bag of saline to mix it

Primes the tubing

And hangs the drip.






Don't let this happen to you.  When it comes to pressors, here is my advice: Hang one, order one.  Remember it.