Ativan IM?

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Can you give this undiluted as IM injection? I know it's rather thick to draw up...

I won't even begin to describe how sometimes I have had to be on the floor or otherwise in an uncomfy situation, injecting it wherever I can get big muscle access... (bracing self for impact...)

BTDT, sister!! :D (brother?)

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Specializes in ED, Med-Surg, Psych, Oncology, Hospice.

I agree whispera. Trying to find that big muscle among the 10 to 12 RTAs holding that patient down got too be just too much and THAT is why I left the state mental hospital.

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Specializes in psych, addictions, hospice, education.

Hey elkpark....what's BTDT? And, I'm sister. Skin access? Hmmm....will the needle go through this denim or not? (bracing for more impact...)

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Hey elkpark....what's BTDT? And, I'm sister. Skin access? Hmmm....will the needle go through this denim or not? (bracing for more impact...)

(BTDT = "been there, done that") And, yes, I have given an emergency injection through clothing -- only once, in nursing school, with my instructor standing right there beside me telling me to do so (psych rotations in school used to be a lot more interesting than they are now, haha!) -- in my own professional career, I've always managed somehow to get to bare skin to give an injection ... :)

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Specializes in General adult inpatient psychiatry.

We give it undiluted IM all the time with our psych patients. Only stipulation is that we must not give Ativan and Zyprexa IM together, it must be two hours in between either one if given IM. Anyone else share this view point?

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Specializes in ER, OR, PACU, TELE, CATH LAB, OPEN HEART.

I am not a psych nurse. Had a suicidal psychotic patient on tele a few weeks ago. Chief of Psych told me give ativan and zyprexa to patient. Patient only took ativan. Why the need to wait 2 hours between administering these 2 drugs. This was an emergency situation with security and pt threatening me and everyone else.

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Specializes in General adult inpatient psychiatry.
I am not a psych nurse. Had a suicidal psychotic patient on tele a few weeks ago. Chief of Psych told me give ativan and zyprexa to patient. Patient only took ativan. Why the need to wait 2 hours between administering these 2 drugs. This was an emergency situation with security and pt threatening me and everyone else.

The rationale that's being spread around my unit is that the combination of the two drugs can cause a pt to bottom out.

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Specializes in Acute Care, Rehab, Palliative.

Where i work the Ativan is given IM diuted with Haldol. Great cocktail.

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Specializes in Med/Surg, Tele, PCU.
I most definitely agree with always checking the info for yourself.... I would suggest reading the package inserts that come with the meds. If you don't have it available contact your pharmacist and ask to have it sent to you. I believe the package insert for Ativan says it is to be given undiluted in a large muscle mass for IM injection. IV is to be ALWAYS diluted.

This leads me to a question.......How's about a patient who is agitated (a somewhat psych patient, but on a regular floor) but has a hx. of COPD and has an unproductive cough. If the patient gets an IM injection of Ativan, since it's undiluted, do you think it cause the patient to aspirate if he/she takes a drink of water or something alittle while after given the injection? Uhm....

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Specializes in Trauma Surgery, Nursing Management.

I used to draw it up with an 18g and then administer it undiluted with a 20g.

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Yes Ativan is very viscus. In psych yes we give it IM daily....if you use a large gauge needle to DRAW ONLY....like a 16 or 14.....it draws much quicker, which in psych is important. Then ALWAYS BE SURE TO CHANGE to a standard gauge IM needle. I once saw a nurse forget to change the needle and ouch!!!! But when you do it multiple times a day to draw up and switch it becomes a habit fast. Just like drawing with a filter needle and switching. And also it stings less with no med on the outside of the needle as it is injected. And no you don't need to dilute it. It does push slow. Any viscus drug does.

And FYI--I know you came here for second opinions......but like said prior its always good to check a med book or even just pick up the phone at your hospital and call the pharmacy and ask a pharmacist--always a reliable source and good cuz unlike a book you can clarify or ask questions about anything you are not clear about. Get to know your pharmacist--thats their job to be a resource.....I've called over the years about a lot and actually learned a lot from some really helpful pharmacists.

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Specializes in Med/Surg, Tele, PCU.
Where i work the Ativan is given IM diuted with Haldol. Great cocktail.

Wow........!that is some powerful cocktail! Thanks for your input loriangel14 ! :up:

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