Do you give mag off pump? - Page 2

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  1. Guide
    Apr 30, '12 by
    Never have, or even heard of that. Doesn't seem safe at all.
  2. Guide
    Apr 30, '12 by
    I have run 1 or 2 g Mag in a 50mL bag wide open via gravity in respiratory distress patients as VICEDRN described, in all 3 hospitals where I have worked.

    Quote from BellaInBlueScrubsRN
    The 20g bag was made by pharmacy and sent up. It had to do with how the doc ordered it. They order on the computer and I believe it came up as Magnesium sulfate: 20gm in 500cc, dose [to give] 2000mg. In the ER, the nurse calls down for meds that we don't have loaded or premixed. So they don't see the doctor's order, just what the nurse tells them.
    Unreal ... that pharmacists at your hospital are willing to leave themselves open to error like that.
    MassED likes this.
  3. Apr 30, '12 by
    Personally, the pumps we have in our hosp are pretty quick to use so I tend to put most of my IVs and piggy backs on pumps.
    If I have mag in a 1L banana bag I will run it to gravity. It is easier to control the rate and give it over a hour. But the mag by itself in a small bag, I always run on a pump. Too easy to bolus a 50ml bag in a couple minutes without a pump.
    20g bag yikes!
  4. Apr 30, '12 by
    We're changing to the 4 hour time on Zosyn too. I forget the details, but it absorbs/ works better if infused over 4 hours. I suspect it will catch on elsewhere soon.
    MassED likes this.
  5. Apr 30, '12 by
    Generally 2G hour on pump is the limit unless its 1) OB for pregnancy induced hypertension/ and its complications, 2) asthma. On Zosyn our facility too has gone to the hour time frame save for the ED we still do 30 minutes because ED doctors generally order more than one antibiotic. To meet the standard, for example in the case of pneumonia all the antibiotics have to be given and if there is a miss you miss the indicator and we are not going to keep a pt in the ED an extra 4 hours just to start a second med, as the floors have a tendency to miss them for us.
  6. Apr 30, '12 by
    We give Mag all the time, always on a pump over 30 minutes.

    Our hospital also gives Zosyn over 4 hours, for that reason I don't see it given too often.
  7. Apr 30, '12 by
    When I worked in the hospital, mag boluses were given over 2 hours with VS done every 30 minutes.

    I have only ever given Zosyn over 30 minutes. Can't imagine giving it over 4 hours... especially with the doses they're on in pediatrics- they'd end up getting like 3 mL/hr. (I don't remember the concentration that pharmacy reconstitutes Zosyn too, bit I remember it usually came in relatively small syringes.) Not to mention, zosyn was never a first line antibiotic for my patients and if they were on it, they were usually also on Vanco and Ceftaz so these poor kids would end up hooked up to some antibiotic 24/7 if Zosyn was a 4 hour thing.
  8. Apr 30, '12 by
    Quote from SMARN
    4hrs?! Wow, why the change? Manufacturer? We still run ours in over 30 min. Longest abx we run in takes 2 hours (vanc, etc). 4 hrs is crazy; as much as we use zosyn, we would def have to change meds.
    It's because by increasing the infusion time to four hours, the concentration remains above the minimum inhibitory concentration for a greater period of time, and dosage can be changed from Q6hours to Q8hours. It's what all the cool kids are doing these days.
    psu_213 and MassED like this.
  9. Apr 30, '12 by
    I've never given mag by gravity, but I've only given it for ventricular arrhythmia, and we have a standard protocol that requires using a pump.
  10. Apr 30, '12 by
    Quote from SMARN
    4hrs?! Wow, why the change? Manufacturer? We still run ours in over 30 min. Longest abx we run in takes 2 hours (vanc, etc). 4 hrs is crazy; as much as we use zosyn, we would def have to change meds.
    It has to do with efficacy and how fast it is eliminated by the kidneys. Our protocol is over 4 hours unless they are on dialysis, in which case we still give it over 30 minutes.