Thank you for the review Doctor. I found your channel after (re)listening to your talk with Ginger Locke of Medic Mindset.

These are amazing vids. My department uses your app. keep up the vids they are beyond helpful

Good video. I like to empty ONE ml of the flush, and add ONE ml of EPI. 1. Faster 2. Less confusion. The EPI syringe is labeled as 1:10,000. It would be confusing whether that label is left intact or written over with a sharpie. A new syringe could be labeled correctly with less confusion. Plus, no need to waste EPI that is often in short supply.

Good video doc, PDPs and specifically push dose epi have all sorts of uses, not only in the ER and ICU abut also in EMS. There is a much easier way to prepare push dose epi as well, especially for us field clinicians no need for any special stopcocks or the like. Take a flush push out one ml, pull back the one ml to give you a one ml air space, take your cardiac epi and pull off the green IV luer lock connector so the needle is exposed for a needle port and then push one ml cardiac epi into the flush and mix well. And mark it with a piece of tape or the like so it doesn't get mixed up with a normal flush. This has the added benefit of not wasting the 900 mcg of epi you don't use which can be used if your patient arrests or to mix more push dose epi. Also in EMS we typically do 10-20, sometime 30, mcg pushes if we are working on very critical patients and that way we can have more hands free faster. This is an amazing tool that should be in every MD's and medic's toolbag for managing critical patients.

@TheHandtevy

4 жыл бұрын

Agree and we do teach this in the Handtevy course. Thank you for your comment.

@SojourningJosephine

2 жыл бұрын

Thank you, Adam. This is also excellent information as it is always great to be resourceful. Would you please explain how you would prepare D10 and D25 from the typical D50 we have on hand?

@patriciadustylynn5802

2 жыл бұрын

@@TheHandtevy so agree. I also found the bristojets/ abbojet markers are always precise, so I draw up the 1 cc epi and add to 9cc NS. (Ive gone back to "cc" vs mL as behind a mask, in a code situation "miligrams" and" ML's" sound too much alike. Also, now that most manufacturers have dropped the "1:10,000" dilution, you may want to readdress. Thanks for all you do! Dusty Lynn UVa

Thanks for posting Doc.

Awesome content

Can you clarify the dosing for peds? Adults are typically maxed at 20mcg (2mL @1:100,000) but if you do the weight based dosing for peds, a 35kg kid can wind up with 35mcg. I get that it's 'titrated to effect' but clearer guidance on individual increments would be good.

@TheHandtevy

11 ай бұрын

Thanks for the question. We recommend maxing out at 1 mL (10 mcg) per dose in peds with a Q2-5 min prn redosing. In my EMS agencies we also use 10 mcg per dose but there are others who will use 20 mcg per dose.

Thank you , but it was better if you add 1ml of epinephrine to the 9ml of saline instead of loosing all the epi in that cup

@TheHandtevy

2 жыл бұрын

Hayder, we agree with you as long as the NS syringe is labeled appropriately. In EMS, since we rarely will use more that 10 mL (in our urban setting) we do this for safety.