IV Push...please help!

  1. I'm very confused about finding IV push rates. I look them up in my drug book, but I keep feeling like it's missing information even though I bought the one that's on the syllabus. Here's some I have found (most in my drug book), and I'm hoping someone can tell me if I'm right:

    Zofran: (from drug book) 4mg undiluted over 2-5 minutes

    Toradol: book says push over 15 seconds, but my instructor told me that they prefer to push it over a minute, and that you would only push it over 15 seconds if someone needed it in an emergency.

    Solumedrol: book says push over a minute

    Benadryl: book says do not exceed 25 mg/min but offers no other guidelines; it's only available in 50mg/mL, so you would just push that mL over 2 minutes right?

    Demerol: I can't seem to find anything in my drug book about this one...I don't know if I'm overlooking something or not
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  2. 5 Comments

  3. by   Triddin
    Does your hospital where you do clinicals have a drug manual? They should give you the rate which you push certain drugs. That's the resource I use at work
  4. by   missnursingstudent19
    We haven't started this semester's clinicals yet. We're supposed to look these up in our drug books to use for a check-off before clinicals even start. I can't get a straight answer on exactly where to find them other than the drug book on the syllabus.
  5. by   BassCatchingNurse
    Yes, follow your drug book. If it says 4mg of zofran over 2-5 minutes, then push 4mg over 2-5 minutes (I push it over 2 minutes all the time, by the way). What about if the doctor orders 8mg zofran IV? Well, give it over 4 minutes.

    You say..."Benadryl: book says do not exceed 25 mg/min but offers no other guidelines; it's only available in 50mg/mL, so you would just push that mL over 2 minutes right?" Yes, you are correct 50mg/ml would be given over 2 minutes. However, the doctor orders 25mg. So, give 25mg, which would be 0.5 of the 50mg/ml vial. Right? So, give that 25mg/0.5ml over one minutes. I personally would give it over 2 minutes. If given too fast it can shoot your patients heart rate up!!

    I use medscape on my phone and lexicomp on my hospital computer all the time. I also use it for compatibility with other meds, precautions, and what to dilute meds with when needed.
  6. by   missnursingstudent19
    Thank you!
    Quote from BassCatchingNurse
    Yes, follow your drug book. If it says 4mg of zofran over 2-5 minutes, then push 4mg over 2-5 minutes (I push it over 2 minutes all the time, by the way). What about if the doctor orders 8mg zofran IV? Well, give it over 4 minutes.

    You say..."Benadryl: book says do not exceed 25 mg/min but offers no other guidelines; it's only available in 50mg/mL, so you would just push that mL over 2 minutes right?" Yes, you are correct 50mg/ml would be given over 2 minutes. However, the doctor orders 25mg. So, give 25mg, which would be 0.5 of the 50mg/ml vial. Right? So, give that 25mg/0.5ml over one minutes. I personally would give it over 2 minutes. If given too fast it can shoot your patients heart rate up!!

    I use medscape on my phone and lexicomp on my hospital computer all the time. I also use it for compatibility with other meds, precautions, and what to dilute meds with when needed.
  7. by   KelRN215
    I get this information from the Pharmacy. When I worked in the hospital, Pharmacy would edit the orders on our eMAR to indicate how long a medication should be infused over. This was pediatrics so we ran almost everything on a pump, including something like cefazolin that was to be infused over 3 minutes. The reason for giving toradol over 1 minute instead of rapidly pushing it is that it burns with rapid administration. At least that's what I've always been told, I've never had it myself. I can't imagine a situation where someone would need toradol emergently.

    Nowadays, if I have to teach one of my young adult patients IVP administration for home IV antibiotics, my Pharmacist tells me how fast they should push it. Usually it's 5 minutes.

    If you're working at a hospital, they should have a formulary that contains this information. Sometimes they make up their own guidelines. For example, standard infusion time for vanco is 1 hr, 2 hrs if the patient has a Redman's reaction. The hospital I liaise at came up with something new a few months ago where, for patients weighing <66 kg, maximum infusion rate is 15 mg/kg/hr and the infusion time needs to be rounded up to the next half hour. So if the patient's dose is 16 mg/kg, the infusion would run over 90 minutes. My Pharmacist said she couldn't find any studies to validate this when they first started doing it. They also do it with all of their patients, even the adult patients who remain at the pediatric hospital because of their diagnoses. So if I have a 25 year old CF patient who only weighs 50 kg because CF patients typically have nutritional deficiencies and is on a standard adult dose of 1g of vanco, the order will say infuse over 90 minutes because the dose is 20 mg/kg even though adult doses are not typically calculated in mg/kg.

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