Vasopressors (Part 1) - ICU Drips

[@ICUAdvantage]

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[@-mudassar9668]

Please use white background. Black background is very irritating.

[@fabiofernandez1378]

11

[@teampalsypunch2213]

Qqqaaqqqqqaaaaaaaqaaaaa!a q a! Q Q!!!

[@sarahjones8992]

As soon as you spike one bag request the next, absolutely!

[@JayArceo_]

I am an ex ICU RN needing to go back to ICU to help out with potential COVID 19 influx here in Australia. Just wanted to say thank you for these lectures. They're excellent brush up on critical care basics.

[@ICUAdvantage]

Awesome to hear! Thanks for the great feedback and glad they are useful for you! Stay safe out there!

[@jasnabucancvitanic7990]

I am anesthesiology resident on maternal leave, my brain is half working but your videos are helping me to stay in good shape for my final exam! Thank you for your " In medias res" videos :)

[@ICUAdvantage]

Congrats on the new baby! Glad my videos have been helpful and wishing you the best as you transition back!

[@YassenAlmezhani-is3vu]

Good luck❤

[@kattrapture]

Starting a position in the Cardiac ICU as a new grad in June. I really have a passion for the cardiovascular system, and landing a position in the ICU is a plus. However, I am super intimidated! Definitely going through your videos to prepare.

[@mqhilaire]

Started the same position at the end of July! Hope it’s going well 🫶🏾

[@lless96]

Started my first rotation as an intern in the SICU. Your videos are really helping me get back that foundational knowledge that I learned all the way back in my first year of school. Thank you!

[@ICUAdvantage]

Great to hear! Best of luck to you!

[@Dreamsofahomesickalien]

Currently doing that now, intern in the SICU and I absolutely love it!! Any tips for someone just starting out?

[@karenkaren3189]

Here’s an important tip from a retired RN. Make sure that you always have your next bag ready! The worst feeling is waiting for the pharmacy or a fellow nurse to quickly mix up a bag while your patient’s BP is tanking. 😨

[@ICUAdvantage]

Yes! So true! Last thing you want is to run out, especially if you are requiring quite a bit. Always have backup bags for all pressors!

[@trishh274]

Seriously! My sister is a pharmD and she always gave me this tip to request medications early. I had a near panic attack a few days ago because pharmacy was 3 hours late getting my inotrope delivered on top of that it wasn't even made even though it was a scheduled medication >=(. The chamber of the IV line literally had a drop left before the dreaded "air in line" message!!

[@cheung7566]

@@trishh274hi! i'm from hong kong! and out of curiosity that don't nurses in prep their own medications/ infusions?

[@trishh274]

@@cheung7566 Hello! It depends on the type of medication and the situation you’re in. I’m not sure what protocols you follow in HK, but in our ICU’s we’re already doing so many things to watch over the patients. It’s a safety measure here in the US.

[@cheung7566]

@@trishh274good to know how the other icu works! thanks!

[@Afaq-ur-RehmanRajput]

Hi I worked at cardiac surgical ICU at TABBA heart institute in Karachi Pakistan. I played with all these medicines, iabp etc etc... Good job man excellent knowledge👍 Now I'm working here in Lahore as RN😎 Please mention TABBA heart institute's name in your upcoming video because I love that hospital alot because I've learned alot from that hospital. Nice place to work and for learning new things aswell. Tears were in my eyes when I was leaving that hospital.

[@NURSEDISCUSSION]

I found this very helpful, for inotrope use in the ICU. Thank you, for all the material and knowledge that has been given. Keep us updated about the ICU, about what we need to know.

[@jeffersonemiliano6619]

Hi, My name is Jeff I am from Brazil and I work in ICU here in Florida. Your video is a very informative and great source of reference. Thanks, so much to share your knowledge.

[@ICUAdvantage]

Hi Jeff! Thanks for taking the time to stop and leave a comment. I really appreciate the kind words and glad that you enjoyed the video. Stay safe!

[@stephanielo4360]

Thank you for these videos! I just started in my hospital's coronary care unit and really appreciate the way you explain critical care concepts clearly and concisely.

[@ICUAdvantage]

So awesome to hear this Stephanie! Congrats on the new position and really glad they videos are finding a good home there

[@sik19999]

thanks, I will recommend this to the junior staff I work with to understand vasopressors. simon, NZ

[@ICUAdvantage]

Awesome! Thank you!

[@Storminlikeelnino]

Since epi is so strong that explains why it is used during codes 💪🏻

[@ICUAdvantage]

Yup and it has a lot of benefits that go well with someone on the edge of life!

[@kellyfrances9435]

That chart at the end was amazing!

[@ICUAdvantage]

Thanks! I really did like that part 😊

[@iagreewithme8577]

Best description and explanation I’ve found on KZbin!!! ❤❤❤

[@ICUAdvantage]

Wow, thank you!

[@montanahermenau623]

Really helped just getting a bigger picture of drips! Brings me back to nursing school’s sympathetic vs parasympathetic lectures! 🤣

[@ICUAdvantage]

Haha awesome Montana! It's amazing how that distant memory stuff comes right on back!

[@charlesjanssens2872]

In Belgium nurses typically make their infusions themselves but in syringes of 50 ml. In our hospital our standard dose of norepinephrine is 4mg/40ml in a 50ml syringe in a syringe pump. 0.05mcg/kg/min is about 2 ml/hours... Every drip will be replaced within 24 hours if not empty.

[@ICUAdvantage]

Interesting! Always cool to hear how things are done differently in different places!

[@zenith322]

So informative with simplified explanation. Thank you so much !

[@ICUAdvantage]

Thank you! I really appreciate that!

[@alomo2000]

Hi Dear, Thank you for your amazing presentation 👏. It's very clear and simple yet it contains every important information that critical care nurses need to know. Great job and God bless you 🙏 🙌 👏 😊

[@ICUAdvantage]

Thank you so much for that. Happy to know you found it helpful

[@X3GibbleX3]

Please do more of these man! Loved it!

[@ICUAdvantage]

Thanks man! Yeah there's actually like 15 drip lessons just in that playlist alone!

[@grattin]

hey eddie, I think that there is some slight confusion. vasoconstriction increases blood pressure by increasing total peripheral resistance (TPR) not by increasing cardiac output. the equation is MAP = CO x TPR. stroke volume is only increased by venous return. increasing afterload actually decreases your stroke volume

[@ICUAdvantage]

Not sure where you feel there is confusion? I'm not stating increasing afterload increases SV or CO.

[@grattin]

@@ICUAdvantage at around 3:30 - 3:45 your diagram implies that SV is a product of three things including afterload. and the voiceover states pressers increase BP by 'impacting' afterload (which i took to mean increasing afterload), thus implying that increasing afterload increases SV which increases CO and thus increases MAP. i think it would be more correct to talk about presser effect on BP under TPR (which you have labelled yourself SVR). i'm being pedantic i know but ICU doctors are very particular. i'm happy to be corrected if i am the one confused.

[@ICUAdvantage]

​@@grattin So when I start talking about the breakdown of the CO equation, I made the transition from talking about increasing BP by increasing SVR to then talk about some of the other effects of pressor usage. I transitioned into breaking down the components of cardiac output to point out the other areas that are impacted that can have positive and negative effects on cardiac output. After breaking down the components, I merely pointed out that the afterload is the primary effect of our pressor usage, but then went on to talk about the impacts to HR, Contractility, and Preload. The point was to also explain about the other effects that will impact our hemodynamics, for good or bad. The purpose was to transition into talking about the adrenergic receptors, and others, that are activated with different pressors, to be able to understand some of the underlying differences between lets say epi and levo. Sorry if that wasn't clear from the video.

[@grattin]

@@ICUAdvantage no worries thanks for your explanation. i think i understand where the confusion was now... i thought you were saying increasing afterload increases stroke volume but you were only relating afterload to BP, not SV at that point in the video. it seems we were in agreement the whole time just took the scenic route getting on the same page, lol. awesome channel by the way.

[@ICUAdvantage]

@@grattin haha scenic route. Yes. I like that!

[@welovekate7513]

New subscriber- great information for an investment banker turned student nurse

[@ICUAdvantage]

Awesome! Welcome aboard! Quite the change of pace there. I can relate. I used to be an Army Infantryman before going to school! Welcome to the world of nursing and glad you like the videos. I find that a lot of students tend to like these videos as well. Browse around. Lots of various topics I've got out there so far!

[@melissahahn4779]

Thank you for the comparison table at the end 19:00

[@ICUAdvantage]

My pleasure! Glad you found that part helpful!

[@fy25song]

Thank you for making pressors easier!

[@ICUAdvantage]

So awesome to hear this Saber!

[@onny1974]

VERY USEFUL AND EASY TO UNDERSTAND

[@ICUAdvantage]

Glad to hear that!

[@bethlewis7485]

Thanks, great presentation. Helps to review these critical care drugs. Been out of ICU for a while but may need to go back

[@ICUAdvantage]

Thank you Beth! Glad these were helpful and I wish you all the best!

[@lincyjohnson34]

Thank you for making these videos. It is really helpful.

[@ICUAdvantage]

You are very welcome Lincy. Happy to be able to help!

[@Ruth2016]

So helpful! I love your videos!

[@mariettaguerrero-porte2703]

Thank you. I love following your lessons ! A good review for me.

[@ICUAdvantage]

Glad you like them!

[@evbedia2505]

Epi standard bag is 4 mg in 250 ml.

[@ICUAdvantage]

It certainly varies by facility

[@netra2151]

Thanks so much! I’m transitioning from trauma stepdown to ccu after som time off. This is great.

[@ICUAdvantage]

Welcome back! Glad you enjoyed the video and wishing you the best in your transition!

[@CarolinaSilva-on5yf]

Thank you this was helpful.

[@nojeemustafa8263]

thanks for your great work . I need your help to prepare a general orientation in critical care management for new graduates and medical students in Sudan especially in these days of pandemic. its only about one hour video or PowerPoint presentation.

[@dgmnhn2098]

Thanks !!!

[@pilluullip7006]

thanks

[@ICUAdvantage]

Welcome

[@jessellegracecarino5681]

hi, what is the difference of A1 and V1 receptors? when its both for smooth muscle comtraction?

[@geddon436]

How Do you determine dosage that you give the patient? What other factors can determine Dosage to give a patient?

[@ICUAdvantage]

Well first it depends on your hospital policy and protocol. Some are very strict about where to start and titration frequencies. I've always had issues with these as they don't give room for adjustments based on rapid changes. I almost feel we need a sliding scale almost like insulin where based on variance from SBP or MAP you make changes. That said, this is a subjective determination. I talk more about some of the logic to these decisions in the next video, the 2nd part, but its going to depend on, for instance, how hypotensive your patient is. Mildly hypotensive is going to start low, and more severely hypotensive you would start at a higher dose. For example Levo, you might start at 2mcg if just falling below your goal MAP. If profoundly hypotensive, you might start at 10. Its not often that I would start higher than that, but in those situations you need to be ready to make rapid titrations up if needed. I wish there was an easy answer, but unfortunately the situations change and the ways in which different people respond to meds is also different. Hope that helps some.

[@geddon436]

@@ICUAdvantage thanks for the explanation. It did help. I am not a nurse, but wanted to learn more about it. I'm considering the nursing field.

[@michellepaul51]

Very helpful! Thanks

[@shannonpickens7695]

Thanks for the video! 👍

[@feliciamiley7714]

🤯 "ɓeta 1's in the ❤ and ɓeta 2's in the lungs 🫁"

[@jaemona1255]

So helpful 🙂🙂🙂

[@ICUAdvantage]

Glad it was helpful!

[@lisamarie5075]

Excellent presentation! Thank you so much!

[@ICUAdvantage]

Thank you Lisa! I really appreciate that.

[@naglaabdo4241]

Excellent. thank you

[@ICUAdvantage]

You are welcome!

[@mroude7834]

You are amazing.... ANY possibility you could go over CVVHD? Please

[@ICUAdvantage]

Thank you so much! And YES! It's coming very very soon 😊

[@mroude7834]

@@ICUAdvantage soon please.... I went from a community like hospital and got hired in a level 1 trauma center where it's a common practice.... I need to understand what I'm doing without following orders blindly, and know my interventions

[@Finess199]

Thanks so much!

[@ICUAdvantage]

You're welcome!

[@carlostorres9943]

Great Video! Thank you!

[@ICUAdvantage]

Glad you liked it Carlos!

[@shayaanp9207]

Thanks for making informative video

[@ICUAdvantage]

You're welcome and thanks for stopping by and leaving a comment!

[@zicozico7470]

Good job buddy

[@ICUAdvantage]

Thank you!

[@claudiajabonillo6900]

very useful for my review

[@ICUAdvantage]

Glad it was helpful!

[@ayyobdahmash2529]

You guys are awesome

[@ICUAdvantage]

Thank you. I appreciate that!

[@vmd1300]

nice lesson!

[@ICUAdvantage]

Thanks! 😃

[@allisoncagney85]

Can you tell me why the last chart says that levophed does not stimulate the B2 receptors?

[@ICUAdvantage]

Great question. Norepi only effects B1 not B2.

[@nealkeeble]

Engagement!

[@venkybly]

Tq

[@ICUAdvantage]

yw

[@rashaal-lamee5781]

please if you can , change the background 's colour

[@ICUAdvantage]

I'm sorry, I can't change it from how its recorded. I've looked at doing it with a lighter background, but the writing just doesn't show up well.

[@mironsk8]

Why do americans primarily use the branded names of drugs and not the generic name?

[@ICUAdvantage]

🤷🏻‍♂️

[@anacasado2930]

It’s easier to pronounce the Brand name.

[@josstremblay9370]

🙏

[@ICUAdvantage]

TY!

[@lukefiglia57]

The handsome enemy subcellularly sigh because duckling extraorally curl along a enthusiastic alphabet. nosy, zesty doctor

[@thepalettewhispererasmr1227]

I’m an ED traveler with 13 yrs under my belt. Your channel has helped me cross the threshold from competent to proficient. Everyone thinks I’m so smart, but really, a steady diet of one of your videos daily while I’m in the shower has made ALL the diff. Highly recommend for ALL specialties. We all deserve to be as smart as the ICU 😘

[@sadamzghool9082]

Great job. Appreciated

[@ICUAdvantage]

Much appreciated!

[@32ahmmed]

Thanks

[@ICUAdvantage]

You're welcome!

[@FastAligator1234]

As a recent new grad, I’m currently two weeks into my orientation in the neuro ICU. I’ve been watching all your videos. These are helping immensely.

[@justbecause951]

Scary they hire new grads into ICU. Good luck!

[@jenny_le]

@@justbecause951 there are new grad nurse residency programs at most facilities now that prep new nurses for this role.... Your mindset is extremely dated. Anyway, I hope you're having a wonderful time on orienting and learning a lot, OP! Congrats on the new job :)

[@justbecause951]

@@jenny_le Its not dated and it's my opinion. I wouldnt want a new inexperienced nurse titrating my drips.

[@Haleyyyy938]

@@justbecause951Even if you started in med surg or where ever, they don’t titrate drips. Every new nurse in the ICU is new to the speciality and the level of care, regardless of previous experience. At least with new grads you know they’re doing their residency and getting a high degree of specialized training from the get go.

[@justbecause951]

@@Haleyyyy938 perhaps thats true..but its not just the drips. Ive met more than enough new icu nurses that think they know it all and dont know crap

[@drewg3087]

Finally landed an ICU job as being a nurse

[@lamoyfray7512]

I'm right there with you with the emotions. I've had 3 shifts so far. I have my 4th shift tonight and Im here brushing up before I go in tonight. lol I plan to watch all the videos on this channel.

[@fuzzyjem3]

man i have 10 years experience on a cardiac intervention unit/stepdown and i just got into the icu and I am overwhelmed. Its normal and will take time

[@ckantrel1977]

[@cmina8016]

I’m 3 weeks into ICU from

[@drewg3087]

@@cmina8016 thanks so much! I’m on my own now and it’s a lot but looking forward to growing.

[@Inthatorder]

I’m a new grad and have been in the ICU for a year, this has really helped me understand why providers choose certain pressors over others for these patients

[@ICUAdvantage]

So glad that you are continuing to grow and learn and grateful that this video was able to help in that!

[@alyssapeterson2004]

If you've been there for a year, then you're no longer a new grad. Congratulations! You are now an experienced nurse 😉

[@anaissparra2292]

new nurses have 2 years of experience or less where im at

[@maddiegirlx4]

Baby ICU nurse here thank you so much!!!

[@ICUAdvantage]

You are very welcome Madelyn! Such an exciting time being a baby ICU nurse. So much to learn and its crazy to look back after a year and see how far you've come. I wish you all the best!

[@jaredjohnson5548]

Same, I start in the ICU next month

[@cattleyaentrolezo2276]

I'm about to be an infant ICU nurse, thank you for these lectures!!

[@RSQswmr2]

I LOVE LOVE LOVE your channel, I learn more from your lessons than I did during my CVICU Residency (ended up going to ED afterwards but I'm looking to go back to ICU). I have been watching these on repeat since I found your channel and I recommend it to EVERY new RN or student RN. PLEASE keep up the great work!!!

[@ICUAdvantage]

Wow, thanks for the awesome comment Steve! Really glad that you've found the channel and are finding the videos helpful for you. And thank you so much for helping to spread the word! I really appreciate that.

[@karenkaren3189]

When I was a young nurse, many years ago, we only used Dopamine drips. Patients got incredible tachycardia. I also remember Isuprel gtts for severe asthma. Glad that we have other options now.

[@ICUAdvantage]

Interesting how things change over time!

[@Deron8564]

Dopamine has largely fallen to the wayside, except to treat bradycardia. In the studies, dopamine showed an increase in all-cause mortality compared to norepinephrine, and it was attributed to dopamine's propensity to cause arrhythmia.

[@carlajoy87]

i am a student nurse extern in the CTICU and i absolutely love this channel. Any chance i get im watching a new video, rewatching past videos and taking notes. i've learned so much on my unit alongside watching these videos. Thank you, thank you and thank you!!!

[@Dreamsofahomesickalien]

Student nurse in the SICU here and I've been binging the ICU Advantage vids since I started school in preparation. It's paid off because I feel like I know at least *something* 😊 Here's to us showing initiative and willingness/curiosity to learn!

[@kathyanagarcon2612]

very helpful! thank you

[@Runzer97]

Thank you! I have a new grad interview for my dream job in an ICU (goal is flight nursing), but my preceptorship was med-surg. Trying to learn as much as I can and this format is exactly how I learn best!

[@ICUAdvantage]

Awesome Collin! Thats great to hear. I wish you luck on your interview and you'll have to let me know how it goes. Glad to hear you've found these videos useful!

[@Runzer97]

ICU Advantage thank you! I’ll be starting the spot in November!! 😊

[@jimmyapple]

Excellent presentation. I actually screen-grabbed the graph at the end. Are you on Facebook and Twitter? I'd like to post it and give you credit.

[@ICUAdvantage]

Thank you for this awesome comment James! Glad you liked it. And yeah that graph at the end helps to make it simple and visual I think. And yes I am on Facebook, Instagram, and Twitter. The username is the same for everything, "icuadvantage". Really appreciate you sharing and spreading the word!

[@lindseycampbell3667]

New grad RN here, just hired to an ICU in a New Grad Residency program. I haven't started orientation yet, but I'm so excited. And I just found your channel and thank you for making these!

[@earnestthompson5136]

Really like the chart at the end and look forward to more about where & when to use them.

[@ICUAdvantage]

Glad you liked the summary chart! :)

[@grahammckain4492]

I was incredibly nervous about starting as a new grad in the ICU until I started watching these videos. thank you!

[@ICUAdvantage]

You got this! Congrats on the new ICU gig. Glad you've found these videos helpful for you.

[@kajmiiir__RN_BSN_CCRN]

Where's Dobutamine and Milrinone?

[@leehughes7031]

Google it at bedside 😑

[@JMM4886]

They are not pressors, they are inotropes.

[@civiln.64]

This is my second week of orientation in the ICU. ICU Advantage has been a wonderful resource to me. Thank you very much. Will definitely recommend.

[@ICUAdvantage]

Awesome! Thank you so much! Glad you like the videos.

[@biancan8842]

Thank you so much for uploading this new series! When I first started in the ICU, these medications were new to me, but these videos have helped me to better understand the pressors than the way I thought myself!

[@ICUAdvantage]

I'm glad that you were still able to find some good info from the videos!

[@dai649]

I am Brazilian nurse starting my carreer in UK your classes are great to get used to vocabulary. Thank you so much for sharing your knowledge.

[@ICUAdvantage]

You're very welcome Dai and glad that this was helpful for you!

[@CUPOFNURSES]

As two ICU nurses we approve this video haha! Great refresher video, thanks!

[@ICUAdvantage]

Haha, awesome and thank you! Glad you liked it. 😊

[@jacquelinedupont7299]

Headed back to the icu after being out of it for a bit, needed a refresh on dosing etc... this was prefect!!! Thank you

[@ICUAdvantage]

So happy to hear this and welcome back!

[@yas-xy3sk]

baby cvicu nurse here - these videos are soooo helpful

[@risamiles6124]

Just subscribed your channel! I’m new to the critical care world. Thanks for your video.

[@ICUAdvantage]

Welcome aboard and glad to have you Risa. Hope that you find these videos helpful in your critical care journey! :)

[@strawbebbiejam]

1 year and 8 months as a med surg nurse. Just completed my first day in the ICU. Needing to relearn a lot of things 😅

[@portiarapelamakgolane1020]

Thank you, you are a born teacher. Keep up updating us about ICU environment and what we should basically know. I find these videos very helpful, now I am confident to use inotropes in ICU.

[@ICUAdvantage]

So great to hear this. Thank you and I'll definitely keep making more videos! 😊

[@lobarita]

Hey Eddie. I got accepted into CRNA school. I have been using your videos to study for a couple years now. Thank you.

[@ICUAdvantage]

Heck yeah man!!! Congrats 🍾 That so awesome to hear and I’m sure you are on cloud 9. Glad to have been able to help in some way.

[@GemmytheG]

Congrats! I’m studying for crna school as well!

[@robsmith4790]

Hi. I’m a UK ITU Nurse. We never use any catecholamines as a fluid bag, due to the caterpillar effect of all pumps, causing a +/- sine wave effect on the receptors. We use syringe drivers with a total 50 cc fluid volume to drug concentration. This gives a linear drug infusion, thus a stabilised vasoactive effect. Typically we use Noradrenaline ‘ [norepinephrine] in 4mg: 46cc dextrose 5% giving a concentration of 80mcg/ cc, then adjust the concentration to the case’ requirement up to 0.99mcg/kg/min

[@alihasnain3882]

Ur lecture is good,but ur writing is toooo tiny unable to see plz work on that otherwise it is amazing

[@ICUAdvantage]

Yes, I do work on making it larger. Thank you. Glad you liked the lesson.

[@leahlott1463]

I'm was a staff neuro RN, now turned travel RN (float pool) during COVID. I have been float pool for stepdown units and most are tele/cardiac PCU. I was never officially trained on drips even though I have been working tele-PCU for a year at several different Westcoast hospitals. They just dont assign me patients on drips because I am a traveler, (hospitals dont train new skills to travelers). Anyway, so now that now COVID has slowed, I am finding many hospitals now expect telemetry/PCU unit travelers to have titrating drip experience. I am self learning in your course. I find it interesting that I sound like the only PCU RN in these "ICU" comments, lol. Thank You ICU Advantage =)

[@ICUAdvantage]

Hey, a lot of the stuff that I talk about on this channel also applies to areas outside of ICU, including PCU/Tele. Certainly some of the stuff doesn't, but it can also be helpful to learn more about what your patients will need or did need before coming to you too. Glad to see you are working to improve yourself and your knowledge base to take care of your patients! Do you plan to continue traveling?

[@JasonNCook]

Love your videos! We are using them for our Critical Care education at our FD. On a side note, what program do you use to illustrate your lessons?

[@ICUAdvantage]

Thank you so much Jason for stopping to leave a comment. Thats awesome to hear and I'm honored that you guys are using these videos! For the illustrations, I just use Adobe Photoshop. I screen cast to an iPad Pro with an Apple pencil and then write directly in to Photoshop.

[@KaerKing]

Dobutamine is not mentioned here though.

[@ICUAdvantage]

Its covered in the inotrope video of this same series

[@jillianmarie77]

New to the ICU, a friend recommended your channel. Thanks!

[@ICUAdvantage]

Awesome! Welcome to the channel and the ICU Jillian! 😊

[@Mona-us6vc]

I’ve been following you since your initial star. I am one of the preceptor for our hospital, I recommend these the new & season nurses. And always a good didactic reference. Continue thanks.

[@KennethBrown-p5s]

Gonzalez Linda Taylor Donald Brown Brenda

[@juliosaenz1567]

Great video! Definitely made the vasopressors more clear to understand. Thank you!

[@ICUAdvantage]

Very glad to hear this Julio! Thank you for taking the time to stop in and leave a comment! 🙂

[@RTGOsiris]

starting in the ICU in a few weeks excited and nervous at the same time, your videos have been helping

[@ICUAdvantage]

Fantastic to hear Joey! Congrats on the new ICU position and really happy to be able to help!

[@majorpain8004]

Would you say this information is steered more towards med students or pharmacy students?

[@happytunevlogs461]

Why we are not using dopamine here in Germany?

[@CC-pm7sd]

Giapreza sounds like a pokemon. 👀 tee hee.

[@paz1733]

no words can express how grateful i am.. thanks a lot!!

[@ICUAdvantage]

Happy to help!

[@reijikashiwaki5168]

Thank you so much. It is informative and easy to understand. Only thing is the writting is so small. It would be great if I can see it clearly as I am one of those who have visual memory.

[@ICUAdvantage]

Sorry, I try to work on my writing!

[@xBassel92x]

Wow, you even went into dosing !!!! This is amazing !!!

[@ICUAdvantage]

Yes! Thank you! Glad you liked it.