[Chris27229]

Many nurses where I work have been giving morphine sulfate IV undiluted using the rule of pushing 1mg/minute, so 2 mg would be given over 2 mins. If giving above 2mg always dilute in 5ml of NS so that it isn't inadvertly given it too fast. I was orienting a new grad the other day and we looked this up in a drug book which recommended always diluting in 5ml of ns and giving it over 4-5mins, for dose ranges of 15mg or less. How are you giving morphine IV for pain control?

[psalm]

I always give over 4-5 minutes so my pts don't get a quick high, some ask for it faster! If a hep lock, I dilute, if in a running IV, I don't dilute. If incompatible with running IV, obviously, dilute, stop IV, saline flush, med, saline flush, and then continue IV. I don't think I have ever given more than 10mg.

[Chaoticdreams33]

The policy for IV morphine where I have clinical is to give 5mg or less undiluted over 1-2 minutes. Over 5mg dilute in at least 5ml of NS and give at 2-3mg per minute. It doesn't hurt to dilute any amount though (as long at the pt can tolerate an extra 5mls) and it doesn't hurt to give it over a longer period of time if you have 5 minutes to push it. I like to give it slowly the first time I give it to a pt to see how they react, then later on I will give it faster.

[KodieRN]

We have vials 10mg/ml. For IVP I waste 1 ML of NS out of a 10ML syringe and draw back the 1ML of morphine giving me 1mg/ml mix. That way it can be pushed slowly 2-5 min and easy to give the right dose

[MLOS]

Typically not diluted where I work, usual dosing of 2-5mg per dose.

Check your facility's policy.

[mamalle]

for my postop patients- normally 2mg at a time from the farthest port undiluted. er, may be different depending on the situation- then I dilute 10mg with 9 cc NS.

[ELKMNin06]

we dont have any hard fast rules, we give per reccommended dose. I usually give morphine via MIVF so I wont dilute it. If I give it through a periph IV then I usually just mix it with some ns so I don't give it so fast. I have had many pts ask me to push it faster.

[Sweetooth EMT-P, RN]

I have alway given MS undiluted no matter what the dose, the key is to just push it slowly.

Sweetooth

[Roy Fokker]

Most of our post-ops come up with PCA pumps - so I just "bolus" a dose from that.

If I'm giving someone IVP, it's usually a "breakthrough pain" scenario (or they have no PCS) and I give it undiluted.

We have different strength pre-filled stocks :: 2 mg/ml, 5 mg/ml and 10 mg/ml (all of these strengths come in 1 ml doses - so I have 2 mg, 5 mg or 10 does per vial/syrette depending on the vial/syrette I choose).


We have similar system for Fentanyl and Dilaudid (different strengths of course!)

Now I have a follow up quesiton:

If you had a choice: Do you prefer to give them IM or IV?

cheers,

[canoehead]

Dilute it, then push it in the highest port available, and it will drip in slowly over 5 min even if you need to move on to something else.