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Diluting IV narcotics = narcotics tampering?



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Jan 28, 2009 03:27 PM

Diluting IV narcotics = narcotics tampering?

by mcknis

I was told the other day that it is now illegal, yes illegal, to dilute IV narcotics because it means that we are now 'tampering' with narcotics. What do you think? We have now been told that ALL narcs must be given via Carpujects and can not be diluted. What is your policy?


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18 Comments
No. 1
from ChristineN
Old Jan 28, 2009, 03:30 PM

Default Re: Diluting IV narcotics = narcotics tampering?
I'd ask to see proof. I work in peds and it's downright unsafe, IMO, to give Morphine, Dilaudid, or other narcs without dilluting them.
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No. 2
from morte
Old Jan 28, 2009, 03:32 PM

Default Re: Diluting IV narcotics = narcotics tampering?
i think someone is a bit looney, and i dont mean the OP.....if the doc wants it run in over so many minutes via a partial fill ....that is what he/she wants.....and i suppose "they" want you to shut off the iv and push it? sounds like you have hmm some one in management who likes their meds
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No. 3
from hikernurse
Old Jan 28, 2009, 05:01 PM

Default Re: Diluting IV narcotics = narcotics tampering?
We always dilute narcs in the NICU, too. We give such small amounts that the baby would get it all at once otherwise. Of course, we never get to use carpujets--as cool as they look .

If you put IV drugs in tubing with IV fluids that are already running, then it is diluted before the patient gets it; would they count that as tampering?
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No. 4
Old Jan 28, 2009, 05:40 PM

Default Re: Diluting IV narcotics = narcotics tampering?
Originally Posted by mcknis View Post
I was told the other day that it is now illegal, yes illegal, to dilute IV narcotics because it means that we are now 'tampering' with narcotics. What do you think? We have now been told that ALL narcs must be given via Carpujects and can not be diluted.
Who told you that? You should ask to see the law in writing.
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No. 5
from mcknis
Old Jan 28, 2009, 07:57 PM

Default Re: Diluting IV narcotics = narcotics tampering?
This was posted per our staff developer today on our hospitals website. I am going to ask her to leave a copy of it in my mailbox and also to see examples of when diluting a med was considered a crime. She advised that when diluting we are tampering with the med. As soon as I saw it, i was like, "you've got to be kidding me woman. are you mad? how on earth is this realistic? also, are we going to start throwing out all of our drug reference books if we are going to rewrite them? it clearly states in our drug guides that MS and dilaudid both have to be diluted if given in a direct route!" ARGH...i talked with another nurse on our floor and she told me, "well P&P change so often so it will probably be back to the old ways again." If only we would look at pt safety for ALL things!!!
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No. 6
from morte
Old Jan 29, 2009, 08:09 AM

Default Re: Diluting IV narcotics = narcotics tampering?
i would be checking with risk mangement and the law firm that rep the hosp.....good luck
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No. 7
from iluvivt
Old Jan 30, 2009, 06:47 AM

Default Re: Diluting IV narcotics = narcotics tampering?
What!!!!! I am assuming you are talking about IV administration. if you are diluting allows you to control the administration rate a bit better as well as dilutes medications that are very irritating to the veins. I find dilaudid to be very irritating,thougg keep in mind some IV medications no how much diluted are inherently irritating with or without dilution. If you give the med at a y-site it gets diluted anyway so the new rule makes no sense. The dilution does not cahnge the property of the drug,unless the diluent is incompatable so the patient gets the dose as prescribed so this makes no sense. Some of the rules are getting so silly and are really obstacles in providing good care sometimes.
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No. 8
from janfrn
Old Jan 30, 2009, 08:33 PM

Default Re: Diluting IV narcotics = narcotics tampering?
So how would you run a continuous narcotic infusion?
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No. 9
from ChristaRN
Old Apr 30, 2009, 12:59 AM

Medical Re: Diluting IV narcotics = narcotics tampering?
Agreed. I also work in Peds and always dilute and administer over 10 minutes or so depending on the drug and the child

Originally Posted by ChristineN View Post
I'd ask to see proof. I work in peds and it's downright unsafe, IMO, to give Morphine, Dilaudid, or other narcs without dilluting them.
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