Hello everyone,
Once again I want the answer to a question I have.
Patient is on dobutamine continously. He needs lasix IV push. Cant the dobutamine be disconnected the IV flushed real good, lasix given, IV flushed again real good then start the dobutamine again rather than the patient being stuck for another IV heplock for his lasix?? Especially if the pt is a hard stick.
What would you do?
IMHO, the answer depends upon many other factors. how much lasix? 40 mg or less can be given over 1-2 minutes and your method may be acceptable, IF the B/P is relatively stable and would not be affected by this short period of being off the dobutamine. If the dose is more than that, a longer period is required for slow injection and this may not be appropriate depending upon the patient's degree of stability. The need for lasix in these patients tends to increase over time, so a longer injection could be required if not now, then in the near future. I am assuming the patient now has only a single lumen CVAD of some type. What are the risk factors for swapping this for a double lumen CVAD? How long will the patient require the lasix? What other drugs might he need? A complete patient assessment is needed to make this decision and it is not limited to the level of venipuncture difficulty.
One other thought - Gahart's Intravenous Medication says there is conflicting compatibility information between lasix and dobutamine. I would check the most recent drug compatibility information on this to see if these can be given together. This information can change frequently. One resource provides quarterly updates. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861