IV Dilantin

[LINUS]

I gave Dilantin IV to a patient the other day. He had D51/2NS going through his IV, and since Dilantin isn't compatible, I had to stop the IV and give the Dilantin through his saline well. I'm still a new grad in training, so I asked my preceptor how to administer it (I knew there were precautions, but not sure what) and she told me to just push it slow (150mg over three minutes). Well, after about two minutes and only 25mg given, the patient started howling and saying his whole hand was burning... If I run into this situation again, how should I administer it? What was I doing wrong? Thanks!

[cannoli]

It's been a few years since I've given it, I think we hooked up a NS flush bag at 150cc/hour, ran in 50cc NS, then pushed the dilantin into the NS, 50mg/minute, then ran in another 50cc NS, then rehooked the mainline.

I've not seen it infiltrate but the patient had a nasty looking arm from it, the vein was red a distance around it all the way up the arm.