When drawing push meds, do you draw the med first? - page 3

by anangelsmommy 8,769 Views | 26 Comments

ok, I am in my last month of school, and I am trying to clarify something I learned in school. I have tried looking it up and online and I cannot find it. Perhaps I can find either a source here or a consensus among the learned... Read More


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    yup, seems like this is the consensus...I appreciate the feedback. I will be working very soon on my own at the hospital most likely so this is why I want to know!!thank you so much for all your input, I definately think that I can do what I am told for now and do what I am comfortable with doing when I am working! I also do homecare and though I do not do IV push at my job now, there are a few new cases that require RN only that look really good that I may orient to when the time comes!! thanks so much for your feedback, I love allnurses!!
    angelsmommy
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    I have never seen any nurse have to reconstitute anything like we were taught in school, it always comes already done so far.

    Here in Australia ans in the UK and Ireland nurses have to mix (reconstitute) their own Antibiotics. This requires knowledge of compatibility of fluids to the meds such as pantoprozloe should not be reconstituted with sterile water but saline unlike most other medications which are reconstituted with sterile water. Also because I have to add most of them to a burette you have to know what meds are compatible with the IV fluids you have running.......... most are not compatible with Hartmanns Solution (compound sodium lactate) or with K+ so the med has to be added to a smaller bag at the right concentration and infused.

    But to return to the original topic I would say draw up the med first to get an accurate dose and then add the dilutent as it is very low posibility that you are going to damage the med by diluting it too much(there is at least one but it fails to come to mind) but if you draw up too much of the med into the diluent you have to discard both (or over or under dose your pt) causing wastage. Best of luck!
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    Quote from ~Mi Vida Loca~
    All the nurses I have worked with get a 10 ml saline flush, the kind that come pre packed and ready. Squirt a few mL's out (enough for how much they are drawing and usually over a little) and put a needle on and draw the med from the vial in a separate syringe to add to the flush, label the flush, put a new cap on it and push that. We keep the vial the drug was in to scan for eMar, I have never seen it done any other way.
    This sounds like what I do, too. Draw up med for accuracy, push a few ml's out of a 10ml saline flush, with needle still on med syringe, push med in to flush syringe, cap, mix, let air out.

    As far as the multi dose vial concern, we are no longer allowed to use multi dose vials more than once (be it a med, or a vial of saine, etc). It seems like a big waste, to me, but their reasoning is that it completely avoids the contamination issue. The only exception to this is insulin vials, of course, we use those more than once.
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    I draw the med in a 3cc syringe, or a 10cc syringe if I'm using Picc line. Then, with the needle still on my syringe, I put the needle into my 10cc of saline and just pull some saline in with my med. And use the remaining flush for the IV. I usually dilute with the same amount as the med.
    I've never thought of pushing the med into the flush syringe. That's a good idea except for the druggies I have, they may think they're not getting anything but saline if I did that.
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    Quote from Karenmaire
    I have never seen any nurse have to reconstitute anything like we were taught in school, it always comes already done so far.

    Here in Australia ans in the UK and Ireland nurses have to mix (reconstitute) their own Antibiotics. This requires knowledge of compatibility of fluids to the meds such as pantoprozloe should not be reconstituted with sterile water but saline unlike most other medications which are reconstituted with sterile water. Also because I have to add most of them to a burette you have to know what meds are compatible with the IV fluids you have running.......... most are not compatible with Hartmanns Solution (compound sodium lactate) or with K+ so the med has to be added to a smaller bag at the right concentration and infused.

    But to return to the original topic I would say draw up the med first to get an accurate dose and then add the dilutent as it is very low posibility that you are going to damage the med by diluting it too much(there is at least one but it fails to come to mind) but if you draw up too much of the med into the diluent you have to discard both (or over or under dose your pt) causing wastage. Best of luck!
    Yeah I have no doubt that it's done, I had a med I had to pick up from Pharmacy that needed to be reconstituted for my kid so I know it still happens, those all had very clear instructions on them for how to do it, what to use and how much and what to do first.

    But doing the clinicals in our hospital I have never seen it down. I have heard though on the Oncology floor the nurses have to mix a lot of their own meds. I don't know for sure though.

    It's interesting how much things are different in different places, I did clinicals at a new hospital tonight and was in the ER. Things done completely different but I really liked it.
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    Quote from cherrybreeze
    This sounds like what I do, too. Draw up med for accuracy, push a few ml's out of a 10ml saline flush, with needle still on med syringe, push med in to flush syringe, cap, mix, let air out.

    As far as the multi dose vial concern, we are no longer allowed to use multi dose vials more than once (be it a med, or a vial of saine, etc). It seems like a big waste, to me, but their reasoning is that it completely avoids the contamination issue. The only exception to this is insulin vials, of course, we use those more than once.

    Yeah insulin is the only one I seen too. Although tonight in the ER I saw them used but things are done very different there. On the floors I have only seen the multi dose insulin and it's only for the PT at that.
  7. 0
    Quote from wlb06
    You don't have IVs? No saline flushes? Please explain that one.
    We're acute inpatient pediatric psych. Our kids are crazy as heck, but we don't admit them until they're medically cleared. It's very rare that our kids even get an IV in the ER. My advice was actually from my experience with IM meds (which is considerable), I noticed after posting the OP wanted IV-specific info.


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