OWWWW/ with or without?

deespoohbear · Nov 15, 2002

I have hear conflicting views on this issue. A pharmacist at our hospital whose opinion I trust more than most of the doctors I work with says that mixing lidocaine with ABX for peds is not a problem UNLESS the child has a known allergy to lidocaine. One of our family practice docs says that it is cruel and unusual punishment to give Rocephin without lidocaine. So, who knows for sure. I work in a small hospital and we get some peds. I have never had a problem yet (knocking on wood) giving lido with Rocephin. Of course, I get an order from the doctor to administer it that way...I wonder what the Children's Hospitals do? Maybe you ought to try and post this on the Pediatric Nursing Forum, maybe you would be able to get more input. Good luck...

live4today, RN · Nov 15, 2002

I worked pediatrics for over a year, and we never mixed lido with rocephin or any other Abx for that matter. Depending on the age of the child, only so many cc's can be administered per injection anyway which sometimes requires two different injections in two different injection sites in order to give the required dose to the pedi patient. :nurse:

RN2B2005 · Nov 15, 2002

Lidocaine stings, too. The only value might be in reducing post-injection pain, and Tylenol or Advil will work better for that.

I've had Rocephin extravasate while I was receiving it IV; painful, but not much more so than lidocaine. When I was a pediatric patient, I always feared the 'fairy juice' (which is what my pediatrician called lidocaine) more than the ABX or tetorifice injections (I was an accident-prone kid). So, on a purely personal level, my vote is 'no' on mixing lidocaine into IM injectables.

prmenrs, RN · Nov 15, 2002

lidocaine stings!!! A LOT!!!

I dunno, I'm kinda old-fashioned, I just follow the directions on the insert.

shablee · Feb 8, 2006

Our pharmicist has a rollodex made up on how to mix every drug we have and on rocephin the only fluid listed is lidocaine --so as anew RN I mixed IV rocephin with lidocaine for a 4 month old .

No problem but the next night for a 12 month old I went to mix it the exact same way and the 10 yr veteren nurse said you can't put lidocaine in the iv-(the insert doesn't specify which dilutent for which route either) so I just mixed another dose in bacteriostatic solution and she was ok with that---

Now I'm wondering if I could have hurt the first baby's heart with the lidocaine??????

TazziRN, RN · Feb 8, 2006

Rocephin is ALWAYS mixed with lido at our facility unless there's a documented allergy to it....unusual in peds. Yes, it hurts, but ya know what? I once gave lido to an adult with sterile water because he had a lido allergy, and I about had to peel him off the ceiling.

As for dividing the amount in the little ones, I get another nurse to go in with me for a "double whammy" so that even though there are two pokes, they happen at the same time so it's over with quicker.