IV push

[greyL]

In school I was taught to dilute IV push medication with saline, but my preceptors have told me this isn't necessary. Which is correct? Also, the couple of times that my preceptor has been with me while pushing meds, she made me feel rushed! How much time do you need to push narcotics and things like protonix? =/

[0.adamantite]

I like to dilute medications as well but I read an article by the ISMP (?) that states that you should not draw up medications from carpujet containers, which are not intended to be punctured by a needle/syringe.

[sapphire18]

I dilute everything in a 10cc saline flush, unless otherwise indicated. It is impossible to push 1cc of something slowly.

[MunoRN, RN]

It is difficult to push 1ml in a 10ml syringe slowly since you're trying to spread out a very short distance of plunger travel over an extended period of time. 1ml syringes however have the same distance of plunger travel, making it just as easy to push slowly.

[Nurse Kyles, BSN, RN]

There are drugs that come in carpujects that should be diluted like Ativan. I do not understand why a carpuject should not be punctured by a syringe with a needle?

[sapphire18]

There are drugs that come in carpujects that should be diluted like Ativan. I do not understand why a carpuject should not be punctured by a syringe with a needle?

Same here, I have never once NOT done it this way...although I've never seen Ativan in a carpuject, as the point of those is to not have to draw it up into a separate syringe. I also just got in the habit of diluting in 10cc flushes since mostly what I deal with are central lines.

[kismetRN]

where I had my first nursing experience as a student nurse - I've seen a lot of terrible IV push practices but then nobody ever gives a damn as long as pt experiences and notices NOTHING

[0.adamantite]

Here is the article, which outlines safety risks associated with drawing up medication from a carpujet. Although I guess there is nothing you can do if you need to attached a 10cc syringe to a PICC or central line (carpujets where I work are usually 2-3 cc syringes(

ISMP survey reveals user issues with Carpuject prefilled syringes

[LadyFree28, BSN, LPN, RN]

I only dilute if it's absolutely necessary. I haven't killed, maimed, or harmed anyone.

^THIS...which leads to...THIS:

I look every IVP up in drug guide.for rate of push and dilution. Safest method.

Your organization should have this information available; when in doubt, look it up.

[LadyFree28, BSN, LPN, RN]

Here is the article, which outlines safety risks associated with drawing up medication from a carpujet. Although I guess there is nothing you can do if you need to attached a 10cc syringe to a PICC or central line (carpujets where I work are usually 2-3 cc syringes(

ISMP survey reveals user issues with Carpuject prefilled syringes

I read the article; what you said below was highlighted as not a standard; rather a recommendation in the article:

I like to dilute medications as well but I read an article by the ISMP (?) that states that you should not draw up medications from carpujet containers which are not intended to be punctured by a needle/syringe.[/quote']

The ISMP states that carpujet containers have a unit dose amount, have the amount where dilution is not necessary; it never stated you couldn't puncture a syringe-just the risks associated with it; most places do not have the luxury of having to prepare a carpujet dose when there is a needless system; ISMP stated a collaboration of nursing staff and pharmacy should provide a protocol and solutions; some committed provide a safety space, review of the six rights (including dosage calc, and reviewing appropriate medication administration) and one time use of the carpujet labeling of med with patient label, and double check with another nurse; at least that is one hospital in my areas does that I am aware of; others have pharmacy mix and prepare to adhere to the ISMP standards.

[classicdame, MSN, EdD]

go to a source, like PDR or Micromedex or Pyxis or Drug book. Always follow manufacturer's recommendations as that is your defense.

[greyL]

I don't think we have carpuject. I've never seen/heard of it.

[Esme12, ASN, BSN, RN]

carpujet is a brand name for single dose meds.....how do your meds come packaged like the narcs.