Random sodium thiosulfate question.

[NYMedic828]

I'm writing up a powerpoint on inhalation emergencies and came across a line in the cyanide protocl.

"Sodium thiosulfate and diazepam MAY NOT be administered via the same IV"

I remember being told this briefly in my original medic class. I can't remember the reason other than that we should be acting as quickly as possible to treat the cyanide poisoning over the seizure. What happens if they contact one another in the same IV?

Self destruct?:unsure:


*update* epocrates says the combination may induce hypotension? But that has no relevance to the same IV site?

 

[jwk]

I'm writing up a powerpoint on inhalation emergencies and came across a line in the cyanide protocl.

"Sodium thiosulfate and diazepam MAY NOT be administered via the same IV"

I remember being told this briefly in my original medic class. I can't remember the reason other than that we should be acting as quickly as possible to treat the cyanide poisoning over the seizure. What happens if they contact one another in the same IV?

Self destruct?:unsure:


*update* epocrates says the combination may induce hypotension? But that has no relevance to the same IV site?

Sounds like a nursing text. Those same texts say I have to have a separate IV to give blood - NOT!

Don't give them at exactly the same time - run/flush some IV fluid in between the two drugs (that takes a few seconds) and you're good to go.

 

[mycrofft]

Get a product enclosure or ask a pharmacist. Some products, even if you "flush", can leave a residue on the tubing or in tubing junctions. Our pharmacodynamics (nursing college, but same course taken by new MD students) said never to co-administer meds labelled as incompatible through the same tubing; they did let us use the same site, though, since there was no appreciable likelihood of precipitation in the IV catheter (at least, in a peripheral line).
I just googled sodium thiosulfate and did not find an interaction, although a batch is under recall for visible particulates.

 

[johnrsemt]

If you are going to hang a Cyanokit you always want a seperate IV for it: it doesn't like alot of different medications; and you almost always run both bottles (if it is a moderate to severe exposure, both under smoke inhalation or straight cyanide exposure) and it takes 15 min per vial or 30 minutes total and that is a long time not to be able to give anything else: including NS or LR.

 

[NYMedic828]

If you are going to hang a Cyanokit you always want a seperate IV for it: it doesn't like alot of different medications; and you almost always run both bottles (if it is a moderate to severe exposure, both under smoke inhalation or straight cyanide exposure) and it takes 15 min per vial or 30 minutes total and that is a long time not to be able to give anything else: including NS or LR.

I know that. But the protocol is worded to say that their is a SPECIFIC contraindication to administering diazepam in the same IV site as sodium thiosulfate.

 

[mycrofft]

Can you supply a direct quote? Maybe it's a linguistic thing.

 

[NYMedic828]

Well folks, i am a moron.

I wasn't intelligent enough to just scroll down and see where it continues to say "as hydroxocobalamin."

So what it really says is

"Sodium thiosulfate and diazepam MAY NOT be administered via the same IV site as hydroxocobalamin."

Thanks anyway lol.

 

[mycrofft]

Question still valid. Good to unroll the last little fold in the product enclosure though!