Penicillin G IM injection?

  1. 0 Has anyone ever given this IM? I had a patient come in with Group A strep and they were admitted to my unit. The order was to give Penicillin G IM injection. The patient had a PIV so the first thing I asked was if it could be given IV instead of IM. I am a peds nurse and the last thing I want to do is stick a child when I don't have to. I asked the resident about this and was told that the IM was specifically for strep A and due to the concentration and delivery this was more appropriate than IV.

    So then it comes up from pharmacy and the med is white and very thick. There was a small air bubble in it and it was so thick the air did not move. It looked a lot like the zinc oxide cream we put on diaper rashes, it was that thick! I showed it to my charge nurse, who had never given it either, and she said it didn't look right and I need to double check it with pharmacy. At that point it was shift change. I hated to pass it on but I did not yet feel comfortable giving that med when it was looking like that. The oncoming nurse agreed it was very thick and she was planning to send it back to pharmacy to verify that it was properly constituted. Not sure what happened with it, if it was always that thick in the vial or what.

    Has anyone given this med IM before? Just looking for feedback.
  2. Visit  anon456 profile page

    About anon456

    Joined Apr '10; Posts: 1,003; Likes: 2,231.

    3 Comments so far...

  3. Visit  tnbutterfly profile page
    Yes, I have given many of those. It is thick and hard to give. And it is painful for the patient as well.......especially peds patients.
    anon456 likes this.
  4. Visit  tokebi profile page
    I never gave it but have received it. Yes it is thick and it was the second-most painful IM injection after BCG.
    Like the resident said, penicillin is given IM because it will slowly absorb and maintain therapeutic level in blood for days, which may be better than multiple IV injections, especially in an outpatient setting. Sorry a kid had to go through that...
    anon456 likes this.
  5. Visit  anon456 profile page
    Yikes! Poor kid! This patient had been admitted and would probably stay at least a day or two for other issues besides the strep A. I feel sorry for the kid and for the RN who probably gave the dose today. It's policy to put lidocaine cream on the site first so hopefully they were able to do that and it helped some.

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