Protocol for admin. IV Phenergan

  1. I would like to know if anyone has the standard protocol for delivery of IV Phenergan. The hospital I work at says dilute with 10-20cc but I was just hospitalized myself ( it sucks to be the patient) and the nurse gave me IV Phenergan with only a 3cc dilution. I questioned her after she ruined my IV site ( and I got cellulitus) and she denied using a 3cc to the IV nurses. I would like to know what the standard protocol is. Thanks for your help!
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  2. 22 Comments

  3. by   Sleepyeyes
    I think there was recently a thread on this topic, but at our facility, we dilute with 9 cc's of NS and give it slow.
  4. by   TinyNurse
    As far as I know, phenergan can be admin undiluted, or you can dilute with NS and give 1ml with 9ml ns.
    I'm a new grad, and always diluted it in school. I like to dilute so i can push 1 ml/min. Safe and easy to figure out.
    My reference during school was mosby's intravenous medications 2003, and my instructor.
  5. by   Rapheal
    We don't dilute. I follow mine with a 10cc flush and ask the patient how the site feels. "How does that feel, any burning?" So far no problem.
  6. by   mhull
    Our hospital policy requires us to push from the farther port and dilute. I haven't had any problems with this so far.
  7. by   Repat
    We must dilute to 10cc - TinyNurse, do you really stand there for 10 minutes??
  8. by   apaisRN
    Our policy is that it must be given through a running IV. Kind of a pain to hang a bag of saline to give Phenergan, but it beats phlebitis. I work in ICU so generally have central lines. I don't know what the CL policy is, I just dilute well and give slowly.
  9. by   stn2003
    policies differ depending on the hosp : / the hospital i am in currently for clinicals says it should be diluted in NS for peripheral lines, and can be undiluted for PICCS, central lines, and ports. The chances of it causing phlebitis are greater in the peripheral veins because they are smaller, so that's why they dilute. Even then sometimes pts complain of it burning a bit : / but when i have given it in PICC lines (undiluted) no one has ever complained of burning or probs with it.
  10. by   VivaLasViejas
    OUCH!! I can't imagine being on the receiving end of undiluted IV Phenergan......all I know is I would never give it that way. Our protocol is to dilute with 9ml NS and give over at least 2 minutes; I give it more slowly than that, because I know how it burns and what it can do to a vein. In fact, I usually push it over 4-5 minutes; as a result, I've never had one single complaint about my administration of IV Phenergan, even when giving it through a saline lock. Nothing wrong with being cautious, and as busy as I get sometimes, I think it's worth taking the time to do IV push meds right so they don't cause more harm than they 'cure'.
  11. by   Spidey's mom
    Quote from mjlrn97
    OUCH!! I can't imagine being on the receiving end of undiluted IV Phenergan......all I know is I would never give it that way. Our protocol is to dilute with 9ml NS and give over at least 2 minutes; I give it more slowly than that, because I know how it burns and what it can do to a vein. In fact, I usually push it over 4-5 minutes; as a result, I've never had one single complaint about my administration of IV Phenergan, even when giving it through a saline lock. Nothing wrong with being cautious, and as busy as I get sometimes, I think it's worth taking the time to do IV push meds right so they don't cause more harm than they 'cure'.
    I've never had one single complaint either . .. never had a vein blow. I'm wondering if some of the pain is just an IV site ready to go bad already? Coincidence maybe.

    We dilute with 9 cc's too.

    steph
  12. by   chip193
    Quote from mjlrn97
    OUCH!! I can't imagine being on the receiving end of undiluted IV Phenergan......all I know is I would never give it that way. Our protocol is to dilute with 9ml NS and give over at least 2 minutes; I give it more slowly than that, because I know how it burns and what it can do to a vein. In fact, I usually push it over 4-5 minutes; as a result, I've never had one single complaint about my administration of IV Phenergan, even when giving it through a saline lock. Nothing wrong with being cautious, and as busy as I get sometimes, I think it's worth taking the time to do IV push meds right so they don't cause more harm than they 'cure'.
    We don't dilute it at our place. And I never diluted it in the field.

    Chip
  13. by   neneRN
    Our hospital policy just changed fairly recently that we have to dilute it in at least 50 cc NS...because there were too many incidents re phlebitis after nurses pushed it undiluted. I used to give it mixed in 10 cc NS over a minute and never had a problem. Did witness another nurse giving it undiluted through a 22 in the wrist- within seconds the pt had bright red streaks up the arm following the vessel path, screaming in pain. We gave her a NS bolus immediately, but the arm stayed red for a while. I think the policy saves the pts from the few nurses who don't have common sense...yea, you could probably push it undiluted into an AC, but into a 22 in the wrist? That's just ignorance.
  14. by   webblarsk
    I dilute with 9 cc and give slow push over 4-5 minutes. Never had a complaint of burning. Just complaints that the med won't work the same since it's going in so slow and that "the other nurses don't do it that way"

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