- Joined
- Apr 23, 2006
- Messages
- 17,916
- Reaction score
- 10,508
Started at a new surgery center. Lol least it isn't a bunch of Vit K and papaverine like my other place.
Lol random drug with no nebulizer in sight. I guess I could put it in an atomizer and squirt it down the tube if necessary.Albuterol bullet for nebulizer. What's the issue?
It is?That is a super high concentration
Almost looks like it's 12.5mg. That's prolly what they meant.It is?
2.5 mg in 3 ccAlmost looks like it's 12.5mg. That's prolly what they meant.
Isnt that 12.5/3? Ive seen lactic acidosis after 25 mg in the ED to 9.It is?
Just squirt it down the tube, enough will get down at usual flows, even without the nebulizer. Won't be too useful in awake patients without the nebulizer components, though.Lol random drug with no nebulizer in sight. I guess I could put it in an atomizer and squirt it down the tube if necessary.
Started at a new surgery center. Lol least it isn't a bunch of Vit K and papaverine like my other place.
View attachment 385231
I have never seen a connectable nebulizer.Nobody here has attached a nebulizer to the circuit and used this? I do it all the time in someone who is in bronchospasm. It’s a very standard concentration of albuterol and costs a small fraction of an MDI.
How often are you getting bronchospasm? Im like twice in 10 years and probably even then it was just a jumpy academics staffNobody here has attached a nebulizer to the circuit and used this? I do it all the time in someone who is in bronchospasm. It’s a very standard concentration of albuterol and costs a small fraction of an MDI.
You still have to order it this way at some of these little hospitals. I don’t know if they then mix it up manually or they have the duoneb. I suspect the former.Before there was a ready-made "duoneb" vial, we used to mix 2.5 mg albuterol vial(above) with 0.5 mg ipratropium vial and administer it nebulized Q4PRN. This was during my last life as a respiratory therapist about 20 years ago.
Nobody here has attached a nebulizer to the circuit and used this?
About 50% or more of my practice is pedi. They come in sick, junky, whatever. I will often give half the neb after we intubate and the other half during wake up. As a bonus for wake up it helps wash out the sevo. But for the same reason watch out if you give this during a case. You will need to give some supplemental propofol because it dilutes the sevo.How often are you getting bronchospasm? Im like twice in 10 years and probably even then it was just a jumpy academics staff
That is exactly right! Had a patient start moving during a case as a resident.…As a bonus for wake up it helps wash out the sevo. But for the same reason watch out if you give this during a case. You will need to give some supplemental propofol because it dilutes the sevo.
So you give the med in a kind of 'draw over' mode? Does that really work? I've seen people put a nebulizer in line with aux O2 going to the nipple thingy on the bottom of the cup but the flow required to actually nebulize causes volatile agent dilution and you have to adjust the FGF/vent to not get Vt and PIP problems. The MDI inhaler adapters are way less hassle.
In the picture I just didn’t attach the oxygen tubing to the bottom of the nebulizer reservoir. You are correct that it will throw off the Vt sensors.So you give the med in a kind of 'draw over' mode? Does that really work? I've seen people put a nebulizer in line with aux O2 going to the nipple thingy on the bottom of the cup but the flow required to actually nebulize causes volatile agent dilution and you have to adjust the FGF/vent to not get Vt and PIP problems. The MDI inhaler adapters are way less hassle.