Epinephrine - Critical Care Medications

[@petagayeg.1017]

You're helping me survive my ICU orientation

[@ICUAdvantage]

Makes me so happy to hear I have been able to help in some way!

[@shilohpeterson5307]

Thank you so much for these videos! Great info for new nurses, but also good refresher for those of us who have been in nursing/ICU for a while

[@ICUAdvantage]

Awesome to hear! That's my whole goal! :)

[@Vectheric]

A chill goes down your spine...

[@Ruffles729]

I’ve just been trying to memorize the effects of these medications without really understanding them. When you explain which receptors medications work, it actually helped a lot. I was able to understand the “why” behind the uses of medications & how they actually work. Thank you!

[@ICUAdvantage]

Yay! Really happy to read this. I was always the same way. It helped me to understand that how and why behind things and it made the overall picture easier to understand. Truly happy to be able to help! 😊

[@Mona-us6vc]

Another thoughtful, factual and visual great learning and knowledge reinforcing video. Thank you.

[@twinklelight1362]

Thank you so much for such comprehensive presentation of the uses of Epi! It helps me a ton in understanding it!!!!

[@michaelangeloenriquez6581]

Your videos are very helpful. Thank you so much for sharing them.

[@risamiles6124]

Excited every time I see new video uploaded. Thanks Eddie🙏

[@ICUAdvantage]

Yay! Always excited to see another comment from you. I do appreciate you. Hope your 2021 is going well. Take care Risa!

[@mafepmjarumay221]

Thank u so much to your channel 💓 I'm new at the ICU and your on point discussions have been helping me understand and bridge my experience with the theory behind it all. Kudos! Keep it up! 🙏

[@ICUAdvantage]

Wow thank you! So glad to read this comment. This is really why I do it. I love to help people make the connections and to try and make more sense of it all. Congrats on the new ICU position as well!

[@hanyelblasy]

Thank you so much, a table with the indications and dosages would be perfect.

[@queencartier9785]

Thanks for this video. When explained in ACLS it is not clear that we are giving 1mg diluted in 10ml. I was thinking we are giving straight 1mg/ml push or something, which was embarrassing to ask in orientation 🤧

[@mohammadghaffari]

Very good 👍 i really enjoyed it

[@ezatullaha.3502]

Thanks sir a lot, I love the way u make big topics easy and understandable!

[@ICUAdvantage]

You are very welcome! This is truly my goal and I'm happy to hear they are well received!

[@joanjhosuka432]

really appreciate your work, more on this please !

[@ICUAdvantage]

Thank you and certainly will do!

[@MrGeelaa]

Really i like this series so please continue this series....i enjoy this lesson

[@ICUAdvantage]

Thank you! And yes, I hope to keep this going every week for a while!

[@riteshchaurasia4953]

Plz describe how does 4:44 a1 vasoconstrictor increases coronary perfusion..since constriction of arteries causes less blood to reach heart..?since systemic arteries are constricted

[@ICUAdvantage]

Great question. By increasing overall vascular constriction, we elevate systemic blood pressure. Essentially think about it this way. We aren't changing the volume of blood the patient has. But if we decrease the total volume available for that blood to occupy (by squeezing our vessels smaller) then we will increase the pressure of that blood in this new smaller volume. Hope that makes sense!

[@kareenelizee]

Is this the inotropic effect?

[@dgmnhn2098]

Thanks a lot !

[@dangmateo00]

Thank you for your video. So illuminating!

[@ICUAdvantage]

You are so welcome!

[@thorpower1015]

Epinephrin for my asthma works great all others albuterol and steroids dont work as well, the hfa inhalers also worsen my asthma but doctors always want to push it on you,

[@SteveG_RN]

Hey your forgetting the B1 receptors in the kidneys that cause the release of renin, effecting intravascular volume and SVR through the Renin Angiotensin Aldosterone ADH pathways. So I say B1= 1 heart and 1 kidney (yes there are two of them, but at least it helps remind of the kidneys), B2 = 2 lungs.

[@ICUAdvantage]

True true true. Not quite as quick, but certainly worth a mention! Thanks for mentioning Steve!

[@beckyfoust2914]

Can you clarify how much you give IV push for cardiac arrest? Is it .1mg or 1 mg? Thanks so much

[@e.g9478]

You are Awesome! Thanks again!

[@ICUAdvantage]

You rock! Thank you!

[@aliakrabi8321]

thank you for the lecture,.just to remind in 3:39 the higher the ration the higher the concentration and vice versa is true, right?

[@ICUAdvantage]

1:1,000 is more concentrated than 1:10,000

[@bahiachibi895]

Amazing 👏 🎉thanks

[@danib0rman]

You are awesome! Thank you for the video

[@ICUAdvantage]

Wow, thank you so much Daniella! You are more than welcome and I appreciate you and taking the time to leave a flattering comment ;)

[@ethanurlings6751]

This is great, but id love some References!

[@طائر-و6ظ]

Thank you ❤️

[@ICUAdvantage]

You’re welcome 😊

[@pirateslife4me]

Going in to the ICU. You're my emotional support channel 🧸

[@ICUAdvantage]

Hahaha I love this!

[@kgrfirdjy]

I am a bit new to giving epinephrine outside of the pen version, but why does the 1:1000 version of epinephrine need dilution? is there a bigger risk of vasospasm and // or tissue necrosis from infiltration?

[@ICUAdvantage]

Good question. When given IV, it is quite potent and can lead to severe tachycardia, hypertension, and arrhythmias, including potentially lethal ones.

[@avantikadogra850]

Thanks for the video ❤️

[@ICUAdvantage]

Truly my pleasure!

[@vickeysimmo4550]

I enjoy listening to you. Has we would say in jamaica.... Man you sell off.... Love you

[@ICUAdvantage]

Haha awesome! I've never heard that one before! Thanks so much!

[@aliakrabi8321]

In cardiac arrest, using a 1mg/mL IV push is it a mistake until i have to dilute it? the AHA cardiac arrest algorithm stated 1mg push

[@ICUAdvantage]

Yes it should be diluted in 10ml

[@王英瑜-g7m]

Thanks for your hard work!! Are you planning to do a video on Levophed and its difference with Epinephrine? Thanks!!

[@wesamzaen5463]

Thank you.

[@ICUAdvantage]

You're welcome!

[@brandonbock4763]

Any study guides or flash cards you suggest?

[@kassava_rae]

Rock It by Tokyo Machine?

[@wasanahdlt749]

Thank you

[@ICUAdvantage]

You're welcome

[@travesjohnson6945]

I love these videos for reference! Can you please do sodium bicarb?!

[@AbhishekSingh-yx6gn]

Bro plz explain doses with example..... thanks

[@jeroomme]

Thank you!!

[@ICUAdvantage]

Glad you liked it Jerome!

[@khfan4life365]

I got injected with some epinephrine when I had a cavity filled. My legs shook so hard that the chair started rattling. It scared the hell out of me and I started crying. The dental assistant came over to me and helped me calm down, telling me to just breathe. Eventually, the tremors stopped and the rest of the appointment was uneventful.

[@ICUAdvantage]

Wow! That does not sound like a pleasent dental experience!

[@chakuututuu2241]

Do they use this for children in the hospital who is 50/50?

[@noorsami5777]

thanks

[@ICUAdvantage]

Welcome!

[@musahebert9656]

Interesting.

[@ICUAdvantage]

Glad you think so!

[@lobarita]

thanks im preparing for crna shool

[@ICUAdvantage]

Awesome and best of luck!

[@SuviniGunasekara]

Thank you for this :)

[@ICUAdvantage]

My pleasure!

[@catherinebernardinoysulat2057]

First comment and like 👍😊

[@ICUAdvantage]

🎉 Woohoo!! Thanks for both :)

[@rekhakadam6393]

Many thanks 🙏🏻 v useful

[@ICUAdvantage]

Glad it was helpful!

[@allymusic9032]

Very nice

[@ICUAdvantage]

Thank you!

[@Brightamen]

Thanks for this video, but I have still not gotten the dose for cardiac arrest, can you elaborate? Do I dilute it and give everything? do I give 0.1mg/10ml or 0.1mg/ml

[@ICUAdvantage]

Dose is 1mg. The concentration administered should be 0.1mg/ml, so 1mg in 10ml's.

[@Brightamen]

@@ICUAdvantage thanks, this is clear

[@jasminejohnston6393]

A female doctor who was tending to a patient having an allergic reaction made a mistake when she held an Epi Pen the wrong way which caused the needle to poke into her thumb and give her an injection of epinephrine that was meant for the patient!

[@caroljohnson3851]

Do you have a good POCKETsize ICU reference book that you recommend?

[@ICUAdvantage]

I used to use the app version of Fast Facts for Critical Care, but they never updated it and it stopped working years ago. You can still find the print version online, but its quite pricey. I wish I had another resource for you.

[@kelseydrew5685]

Yes!!

[@ICUAdvantage]

Yay!!! I wish I could use GIFs on here. I'd so drop the excited Kermit right now lol :)

[@stephengolden6080]

Technical.

[@ruthtarasko3849]

Hi Eddie. Can you further explain how vasoconstriction decreases hydrostatic pressure?

[@ICUAdvantage]

Great question Ruth! So hydrostatic pressure in the capillaries is controlled by pressure in the capillary bed. The way our bodies control this is by increasing or decreasing blood flow. More blood flow = more pressure. Thus vasoconstriction decreases this blood flow and thus the pressure created. Hope that makes sense 😊

[@damianbrandt253]

@@ICUAdvantage I’m confused. I thought that the reason why pressors improve perfusion is that the vasoconstriction that they cause increases hydrostatic pressure until it exceeds oncotic pressure and so keeps fluid flowing into the tissues (which is what perfusion is, right?). What am I missing? Why does vasoconstriction improve perfusion in the heart (which is good) but not in an edematous larynx (which would be bad)?

[@ICUAdvantage]

@@damianbrandt253 Hey Damian, so perfusion is about adequate delivery of blood through the capillaries, to which have a minimum pressure is required to ensure enough blood flow needed to delivery adequate oxygen. While it is part of the component that determines the hydrostatic pressure, that is looking at the movement of fluid from the blood to the interstitial space. Here you are correct that oncotic pressure acts to pull that fluid back and typically should balance each other. Both the arterial pressure before the capillary and the venous pressure after the capillary both influence what the hydrostatic pressure will be in the capillary bed. This is seen in extreme within the kidneys, which explains part of how they control filtration rates. That said, of these 2 components, vasoconstriction on the arterial side (as opposed to vasodilation) on the venous side, has the greater impact in reducing hydrostatic pressure, hence the advantage of epi in reducing hydrostatic pressure and reducing laryngeal edema. Perfusion requires the diffusion of gases from capillary bed across all cellular and extracellular layers. This process does not require fluid shifting out of and back into the capillary bed (although, I'm sure in some small way this does impact the diffusion of gases). I guess ultimately, hydrostatic pressure and fluid shift is a consequence of increasing perfusion pressure yes, but if we are increasing perfusion pressure to meet minimum needs, we are not, generally, producing enough hydrostatic pressure leading to increasing amounts of fluid shift in the interstitium. I hope that makes sense!

[@damianbrandt253]

@@ICUAdvantage That was very helpful, thank you! Based on your explanation and a little Googling with a coworker, I figured out what I had been misunderstanding about pressors: I thought that the fluid had to pass into the interstitial space for gas exchange to occur. I was visualizing a blood vessel flowing through a sponge (i.e. tissue). Squeezing the blood vessel caused more fluid to flow into the sponge. However, this visual explains edema better than perfusion. Perfusion, as you rightly pointed out, happens when the blood stays in the capillaries, not when it leaks out into the tissues. What I had been missing was a basic rule of fluid dynamics: If you decrease the diameter of a pipe that has fluid flowing through it, the velocity of the fluid will increase. More blood flowing past each point in a capillary bed per minute means more gas exchange and hence more perfusion. Thanks again! Really appreciate everything you do.

[@bellalover231]

where can I find the lesson notes?

[@ICUAdvantage]

Thank you so much for your willingness to support this channel Melinda! The link to the lesson notes are found on the "Community" tab of this KZbin channel (kzbin.info/door/5ADeLt8ckSBvfz0C47qbGQcommunity). I post the links to the new videos there as well as the link to the Dropbox and the password for the month. Let me know if you have any issues and thank you again!

[@doristhecoder765]

Another one! I didn't know about the use in Asthma

[@ICUAdvantage]

Less common, but can be used :)

[@fatimazainab3406]

❤

[@ihavecrit]

Im just here to just see different types of medicine just in case I need it in some situation.

[@ICUAdvantage]

Welcome

[@gravelgirls]

pump us up with adrenaline !

[@TXNAT1VE]

Primatene Mist entered the chat

[@brittanythegreat7354]

L.