Will diluting particular viscous drug improve run-back?

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    I had to give a particular viscous IM injection last night that is okay to give undiluted, but I had some run back. Drew with 18g, injected with 22g 1.5". In Deltoid. Unruly patient. Didn't have order for the other common drug mixed with it, so only gave the viscous one.

    I am assuming diluting it 1st would improve run-back. Am I generally correct in that thinking?
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  3. 5 Comments so far...

  4. 0
    Is there a reason you don't tell us the name of the drug? I don't think I'd dilute an IM injection. Again, it's hard to say without more info (drug, mls given...)

    ~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~
  5. 0
    Diluting the med only means that you have to inject a larger volume. It would also make the injectate "thinner" which I would think makes is more likely to run out of the site. I would go with the Z track method.
  6. 0
    I also find it odd that you have to dilute an IM drug. If you think about it, you want to keep the drug exactly where you put it, which should happen if you gave it in the right site, undiluted and with Z-track.

    What's the drug in question? Sounds like it's a benzo or dec (long acting).
  7. 0
    I didn't name drug because this site seems very touchy on TOS violations and threads I searched said refer to drug book, but drug books don't always go into detail.

    Ativan of course.
  8. 0
    Quote from adnrnstudent
    I didn't name drug because this site seems very touchy on TOS violations and threads I searched said refer to drug book, but drug books don't always go into detail.

    Ativan of course.
    No worries! Naming a drug by itself doesn't violate TOS. Name a drug, a patient and exceptionally specific details, and yes, that could start leading you into trouble You're fine.

    Figured as much: Ativan's notorious for being viscous. But depending on how much you inject, a larger muscle may be the better option for the Ativan. 1.5mL of injection solution total is the max for a deltoid, maybe 2mL if they've got a very beefy muscle. You may have been better off going for the vastus lateralis or a glute.

    I'll bet the other drug in question (the "common" one) is Haldol. While I'm here, a good trick for drawing up Ativan: draw up the Haldol first, inject into the Ativan vial, then draw the mixture back into the syringe. A LVN in the ER taught me that one...wish I learned it earlier.


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