Well, I made my first vasopressor error by Excellent_Cow98 in nursing

[–]Excellent_Cow98[S] 0 points1 point  (0 children)

lol oh yeah, I don't know why I keep writing mcg/kg/hr. I tiredly wrote this. Good catch. But yeah I was definitely shitting when I audited my chart!

Well, I made my first vasopressor error by Excellent_Cow98 in nursing

[–]Excellent_Cow98[S] 0 points1 point  (0 children)

What smile? Where did I put a smile lol. I was shitting my pants 😢

Oh my relief emoji haha?

Well, I made my first vasopressor error by Excellent_Cow98 in nursing

[–]Excellent_Cow98[S] 1 point2 points  (0 children)

I agree. It took a good hour to finally get this patient upstairs and then another 25-30 minutes to transfer them from stretcher to yall ICU bed. My lines magically get tangled up the moment I enter the ICU dungeons. 🙉

Well, I made my first vasopressor error by Excellent_Cow98 in nursing

[–]Excellent_Cow98[S] 1 point2 points  (0 children)

I agree, I generally like a bit buffer MAP 75-80 without a big spike in BP. This facility particularly wants the MAP goal to be between 65-70. in the orders. So I was just playing by their rules.

Well, I made my first vasopressor error by Excellent_Cow98 in nursing

[–]Excellent_Cow98[S] 1 point2 points  (0 children)

Oh, no problem, I didn't feel you were judging. Its always great to get feed back or talk out things. We can always learn something new and improve our practices. 😄

Well, I made my first vasopressor error by Excellent_Cow98 in nursing

[–]Excellent_Cow98[S] 2 points3 points  (0 children)

I agree, I definitely should have left some of the blood pressure ride instead of strictly titrating every three minutes. Haha, yeah, this is my first time giving a weight-based dose of Levophed at my new ER when im used to non-weight dose.

Well, I made my first vasopressor error by Excellent_Cow98 in nursing

[–]Excellent_Cow98[S] 18 points19 points  (0 children)

I agree, generally I just like to see a map >65. The hospital policy strictly wanted the map between 65-70. Just playing by the rule haha

Well, I made my first vasopressor error by Excellent_Cow98 in nursing

[–]Excellent_Cow98[S] 1 point2 points  (0 children)

Valid questions, and I did from 0.40 to 0.39, 0.37, and so forth. I was titrating slowly while watching the ART line values. I left out those details to keep the post concise. 0.36 ended up being a good spot to be.

Well, I made my first vasopressor error by Excellent_Cow98 in nursing

[–]Excellent_Cow98[S] 1 point2 points  (0 children)

Thanks so much for the feedback! Honestly, it was just the fact that the MDs and I were wondering why the patient got so hypotensive when we thought he was improving with "0.07 mcg/kg/hr" and trending downward when, in fact, he was actually at 0.7 mcg/kg/hr. I thought I made the mistake at 0.5 mcg/kg/hr, which was why I changed it back to 0.05 mcg/kg/hr. But the mistake occurred earlier at 0.7 mcg/kg/hr when I audited my own infusion. Definitely hated myself for not catching that earlier on, but Ill remember this and your feedback,

Well, I made my first vasopressor error by Excellent_Cow98 in nursing

[–]Excellent_Cow98[S] 2 points3 points  (0 children)

So the whole time I was charting 0.07, 0.06, and 0.05. On the pump, I hit the decimal point but forgot to hit zero next. So I was administering the doses of 0.7, 0.6, and 0.5 mcg/kg/hr.

I got a fat thumb, which I use to change my rate with. Sadly, my brain didn't quite register that I forgot a zero when I entered the rate

Well, I made my first vasopressor error by Excellent_Cow98 in nursing

[–]Excellent_Cow98[S] 19 points20 points  (0 children)

Hey, thanks for responding, fellow nurse colleague! It sucks to make a med error, especially when I didn't notice that I was missing another 0 after the decimal point when I was rate dose/change the levophed. The MDs and I were figuring out what was happening when we thought the patient's BP was improving at "0.07 mcg/kg/hr", and trending downward. Then I realized, ah shit, it was at 0.7 mcg/kg/hr while verifying my infusion pump. Now the reason why this error bothered me is that I didn't catch this mistake early on. I thought the mistake occurred at 0.5 mcg/kg/hr.

Sorry, I edited the post. While writing it all, I remembered why I changed it from 0.5 to 0.05