steps to drawing up demerol and vistaril?

mwbeah · Sep 29, 2005

Can someone direct me to a website or tell me tne steps in drawing up these two medications. I know about checking the orders but my question is do you put two minims of air in before you inject. ALso do you put the filter needle on before drawing up the vistaril, and the needle off the demerol. I would appreciate it if someone could take me through this step by step or direct me to a website that would tell. Thanks!

http://www.drugs.com/PDR/Vistaril_Intramuscular_Solution.html

Link may help you with the interaction with Demerol. As for the drawing up into a needle, I would assume these are single use vials so it shouldn't make a difference which one you draw up first. I do know that Vistaril is in suspension and I personally haven't mixed it with Demerol (I only use demerol in low doses for shivering). It may or may not precipitate if mixed, I don't know.

I do know that you don't need a filter needle for demerol. But, do whatever your instructor is telling you because on that day that is always the right answer (i.e. whatever you instructor is telling you b/c it is her/his license).

You do have to ensure proper IM placement because subcutaneous injections of these two could cause irritations or necrosis in some instances. Also don't forget to aspirate a little bit to make sure you aren't in a vessel. I personally don't inject air into the muscle.

Hope this helps a little.

Mike

VickyRN, MSN, DNP, RN · Sep 29, 2005

Can someone direct me to a website or tell me tne steps in drawing up these two medications. I know about checking the orders but my question is do you put two minims of air in before you inject. ALso do you put the filter needle on before drawing up the vistaril, and the needle off the demerol. I would appreciate it if someone could take me through this step by step or direct me to a website that would tell. Thanks!

Yes, filter needle always before drawing up medication from ampule. Demerol and Vistaril are compatible in the same syringe for IM use only (never give vistaril IV!). Change needles before injecting into patient. Make sure you landmark correctly, deep intramuscular, because vistaril and demerol both can cause serious tissue and nerve damage if injected incorrectly - not deep enough (subcutaneously) or in an incorrect location (around a nerve). After giving the injection, always chart the site and mode of the injection, (make sure you mention that it was given deep IM), patient tolerance and reaction to medication.

Daytonite, BSN, RN · Oct 2, 2005

I've always drawn up the Demerol first because it is a narcotic and I want to get the dosage exactly right. If I draw up the Vistaril first, then the Demerol and decide I've drawn up too much Demerol, I can't be accurate about putting the right amount of Demerol back into the vial since it is now mixed with Vistaril. I believe there is controversy about drawing up air into a syringe just before sticking the patient and injecting the medication IM. I was taught years ago that the small amount of air was to clear any medication remaining in the core of the needle. I've heard that some authorities are saying that the markings on the barrel of the syringe include any amount of medication that will be left in the needle. My own opinion is to draw up the air bubble and give the little extra of the Demerol as a courtesy to the patient. If you are using a filter needle it is used to draw up the medication into the syringe. You then change to a beveled needle of the desired gauge to do the actual injection into the patient.