Butterfly Injections

[1fastRN]

Does anyone actively practice this or come across this in their ERs?

A couple weeks ago I had a treat and release patient who didn't need a line... the doctor ordered IV toradol and I clarified the order with him. "He doesn't have a line, I can start one. Did you want it IV or IM?"

His reply, "You can just butterfly it in or give it IM if you want."

I was completely confused because I had never even heard of this... this isn't the nicest doc, so I just gave it IM to save myself the embarrassment. So of course I googled it. I never learned about this method of med admin in nursing school nor have I ever seen it used. I'm guessing because a good portion of our patients have lines or just get PO/IM if it's a simple treat/release kind of thing.

Does anyone actually do this?

The only butterflies we have are the ones with the vacutainer... do you just use this with a flush and syringe instead? Is this outdated or just a rare technique?

Not sure if I'll ever end up using this method, but for curiosity sake. Sorry if this is a stupid question!

[Anna Flaxis, BSN, RN]

I've only ever used butterfly needles for draws, but yes, you can inject through them as well. Kind of a hassle, though. I'd have gone IM too.

[boyfactory]

I have used a butterfly a few times with a syringe for medication administration. They are perfectly usable for short-term medication administration (less than 2 hours). IM is fine for some things, but if the med was ordered iv and you don't want to start a line, butterflies are fine. Keep in mind, some dosages are different from IV vs IM...like toradol.

[turnforthenurse, MSN, NP]

Keep in mind, some dosages are different from IV vs IM...like toradol.

Yup. We never give 60mg IV at one time....that's the IM dose. for IV it's always 30mg.

[Lunah, MSN, RN]

for IV it's always 30mg.

Some of our docs order 15mg IV, it's often as effective as 30mg. Just FYI, in case you run into that order, it's legit. :)

[turnforthenurse, MSN, NP]

Some of our docs order 15mg IV, it's often as effective as 30mg. Just FYI, in case you run into that order, it's legit. :)

Lol yes, that's ttrue, too

[flyingchange]

I had a homecare infusion client whose RN wife wanted to give his infusions via butterfly as she was not comfortable with IV catheters. His infusions only lasted for 15-30 minutes. All the research I turned up indicate that butterfly infusions are safe for up to 2 hours - although you'd have to monitor it like a hawk and the pt would have to stay basically motionless.