Administering IV medications SLOWLY

[rhan101277]

I have a question about this, also with an example. Say you have to give a morphine dose of 10mg. Protocol states to push slowly over 3-5 minutes. So you just sit in the back and push a little bit then wait and push more? Seems like you would have to tape a syringe to their arm, unless they make little boluses or you have to waste most of a bag of it. Most of ours come in the little glass medication containers with the rubber stoppers. I am unsure of the concentration or volume. :unsure:

 

[ki4mus]

I have a question about this, also with an example. Say you have to give a morphine dose of 10mg. Protocol states to push slowly over 3-5 minutes. So you just sit in the back and push a little bit then wait and push more? Seems like you would have to tape a syringe to their arm, unless they make little boluses or you have to waste most of a bag of it. Most of ours come in the little glass medication containers with the rubber stoppers. I am unsure of the concentration or volume. :unsure:

The vast majority of meds can be put in a 10cc syringe with sterile water or saline (10cc saline flush) taking up the rest of the volume that the drug its self does not, this makes it easier to give it over longer periods of time and also dilutes it so it doesn't sting near as bad going in.

the little glass containers with rubber stopers, are they carpujects, or just standard ampules?

 

[AZFF/EMT]

Like stated above I would normally draw up extra saline. I do npot like the carpujects at all. I would rather have all drugs in vials, much easier and more versitile in my opinion.

 

[ResTech]

Seems like you would have to tape a syringe to their arm, unless they make little boluses or you have to waste most of a bag of it.

What do you mean?

 

[rhan101277]

The vast majority of meds can be put in a 10cc syringe with sterile water or saline (10cc saline flush) taking up the rest of the volume that the drug its self does not, this makes it easier to give it over longer periods of time and also dilutes it so it doesn't sting near as bad going in.

the little glass containers with rubber stopers, are they carpujects, or just standard ampules?

Well I am confused on how to administer the drug over 3-5 minutes as 10mg is not much to push.

Do you just draw of the med into the syringe, then change out needles. Then administer drug through the drug port on the iv drip set? If so then you have to clamp off fluid for 3-5 minutes and somehow have the syringe in a convenient area so you can push it little by little.

Maybe I am sleepy but can someone give me a step by step on administering this dose and how to do so in 3-5 minutes. Giving the medication through the med port on a iv bag doesn't make since as you are going to run out the bag in 3-5 minutes.

P.S.

If this post seems silly I am sleepy.

 

[usalsfyre]

Push a milligram or two, take the syringe off, watch for effect. Don't forget your roller clamp closed all the way down will prevent most backflow and you should be flushing you meds in on most patients.

 

[ki4mus]

Well I am confused on how to administer the drug over 3-5 minutes as 10mg is not much to push.

Do you just draw of the med into the syringe, then change out needles. Then administer drug through the drug port on the iv drip set? If so then you have to clamp off fluid for 3-5 minutes and somehow have the syringe in a convenient area so you can push it little by little.

Maybe I am sleepy but can someone give me a step by step on administering this dose and how to do so in 3-5 minutes. Giving the medication through the med port on a iv bag doesn't make since as you are going to run out the bag in 3-5 minutes.

P.S.

If this post seems silly I am sleepy.

depending on the med I just give a little bit, wait for a minute then give a little more...

and we don't change out needles, we use needleless drip sets..

but if it's something thatis given in 2-3minutes I just push the 10cc slowly.

and as for above, I don't like the carpujects either, we just push the meds out of them into a standard syringe..

 

[DV_EMT]

yeah... 10cc's can be given slowly... if the drug is compatible with SW or NS just draw it up to make a total volume around 10cc's.. that was you can regulate it better. just remember that when you dilute it... it lowers the concentration (mg) per cc.... so if you want to give full strength... give the whole syringe...

 

[rhan101277]

The syringes we use have threaded ends and you screw on the needle. Draw up the medication, then you are saying remove the needle and screw it on the threaded medication port on the iv line and just let it sit wherever.

 

[DV_EMT]

It's called luer lock... And yeah... Do that... Just be sure to flush the line after

 

[Ridryder911]

Know what is scary, it is basics that is answering .........

R/r 911

 

[Akulahawk]

Know what is scary, it is basics that is answering .........

R/r 911

I'd be happier with basics answering correctly than with an MD/PhD answering incorrectly...

 

[rhan101277]

Know what is scary, it is basics that is answering .........

R/r 911

Well I haven't been working any since April. I have only spiked a couple of bags most paramedics I worked with wanted to do all of their stuff. So I am learning about all the ports and such for the first time. I hope to get more knowledge in clinicals and such.

I have never had to push medications through the iv tube either as basic's can't do it.

 

[ki4mus]

I love how people complain about me posting on ALS discussions becouse I have "EMT-B/paramedic student".......but the things is, ya'll have no idea what I did before this....I've been in medicine longer than a lot of my medic school preceptors.....

 

[Jon]

Know what is scary, it is basics that is answering .........

R/r 911

Man... I wish we had a "Like" button like Facebook does... because this comment deserves a big 'ol Thumbs up.

As for the OP's question - if it needs to be given over a few minutes, you just slowly push it.... it isn't difficult.

 

[8jimi8]

Push a milligram or two, take the syringe off, watch for effect. Don't forget your roller clamp closed all the way down will prevent most backflow and you should be flushing you meds in on most patients.

Almost. You should flush the line after administering iv meds in all patients.



What you do first is check the compatability of your drug with the diluent and the fluids you have running. Then you draw up the drug and diluent in a (most likely 10cc) syringe. Clean off your dripset port with alcohol and then attach the syringe. pinch off the tubing behind the syringe and push your drug slowly over time. If your diluted drug is compatible with what is hanging in your bag, then you can release the pinched tubing to further dilute the drug that you are pushing (but don't push the drug while your tubing is unclamped because your drug may not go the direction that you want it to.)

If your drug and diluent are not compatible with the fluids you have running you must use a compatible solution to flush the line before letting the hanging fluid run back into the line.

They key item that the OP is not understanding is that small amounts of drugs are diluted before pushing them. It is very hard to push a few CC's over 5 minutes.

i almost didn't post this because if you don't understand this very basic concept you shouldn't even be considering touching an intravenous drug or a patient's iv line.

 

[Smash]

I'd be happier with basics answering correctly than with an MD/PhD answering incorrectly...

Amen. I don't care if the janitor answers, so long as it is correct.

 

[DV_EMT]

Know what is scary, it is basics that is answering .........

R/r 911

well...its pretty straightforward if you think about it logically...

Compatibility is my big thing (coming from the pharmacy side of me). There are a few drugs for instance that you can dilute with 1% lidocaine as opposed to NS or SW. but generally speaking... if you don't know, don't do.

So long as its compatible... thats the important thing!

I'd of course recommend getting micromedix... its a good program that can help you in the field (mobile version)

 

[rescue99]

well...its pretty straightforward if you think about it logically...

Compatibility is my big thing (coming from the pharmacy side of me). There are a few drugs for instance that you can dilute with 1% lidocaine as opposed to NS or SW. but generally speaking... if you don't know, don't do.

So long as its compatible... thats the important thing!

I'd of course recommend getting micromedix... its a good program that can help you in the field (mobile version)

MS is dispensed in say, 10mg/1cc. Dilute 1 mg MS with 9 cc sterile (from the IV bag for example) saline in a 10cc syringe thus, making the concentration easy to manage. Push as needed or as directed by medical control/protocol.

I tape the vial and the capped syringe to the bag when so that it doesn't get lost and any waste can be witnessed by staff at the ER pretty quickly...no muss-no fuss. Loose narcs sink Medics

Bacteriostatic water or sterile saline is generally what's on an ambulance and is what should be used for dilution. IM is another choice for delivering MS.

 

[DV_EMT]

Know what is scary, it is basics that is answering .........

R/r 911

lol... we're smarter than your average basic!