Can an RN push ACLS drugs if not certified under doctor's order during a code?

Nurses General Nursing

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Might be a stupid question, but can an RN who is only BLS certified push drugs during a code on the floor if not ACLS certified when ordered by doctor?

Specializes in ICU.
I believe you, but I'm shocked none the less. ICU's here push any med in the pharmacopoeia that's available and proper with an MD order. Maybe it's because I'm on a Neuro ICU, but we push a lot of versed.

It's always interesting to see how the job is different from place to place.

I agree, I work in ICU and push Versed all the time. I don't know of any ICU where the nurses are not trained in conscious sedation...

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Specializes in Emergency Dept. Trauma. Pediatrics.

A lot of nurses in the GI labs here are trained in conscious Sedation as well and push a lot of versed. They have a large ranged scale in amounts and use their judgement on whether to give more or less and so on.

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On the other hand, many hospitals have their own policies about administering certain drugs, in terms of training. For example, I can give IVP Versed in the ED, having been trained in Conscious Sedation, but a floor or ICU nurse cannot.

That's weird, your from pa so I'm assuming you work in PA, and the hospital I did my ICU clinical at was able to do IVP versed in the ICU....Weird.....what area of PA do you practice in??? My clinical was in the philly area maybe if you practice in the middle more rural area it's different?

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Specializes in Neuro ICU and Med Surg.
On the other hand, many hospitals have their own policies about administering certain drugs, in terms of training. For example, I can give IVP Versed in the ED, having been trained in Conscious Sedation, but a floor or ICU nurse cannot.

Why wouldn't an ICU nurse not be allowed to push versed? That seems strange to me. I work Neuro ICU and we give it all the time. I can see a floor nurse not being able to push.

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Specializes in Neuro ICU and Med Surg.

We had a pt in SVT one night we gave 6mg adenosine, and HR slowed but sped back up but in A Fib with RVR. Doc on call asked for another adenosine dose. We told her no, you need to switch to cardizem or another med. Doc kept asking we kept refusing. Finally she ordered Cardizem bolus and drip. If we didn't know what drugs did what then there could have been a different outcome.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
That's weird, your from pa so I'm assuming you work in PA, and the hospital I did my ICU clinical at was able to do IVP versed in the ICU....Weird.....what area of PA do you practice in??? My clinical was in the philly area maybe if you practice in the middle more rural area it's different?

I'm sure it's hospital policy. Generally speaking, an RN can administer any medication that's ordered by a physician. But some hospitals may require certain skills check off or certification for certain meds.

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Specializes in ER, TRAUMA, MED-SURG.

I now (we live in Louisiana) when I was still an LPN I was able to push ACLS drugs since the MD was there.

In later time after I finished RN school before getting to my ACLS class I was allowed to push IV ACLS meds if the doc was in the room. Hope this helps!!

Anne, RNC

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Specializes in Emergency, Pediatrics.
I now (we live in Louisiana) when I was still an LPN I was able to push ACLS drugs since the MD was there.

In later time after I finished RN school before getting to my ACLS class I was allowed to push IV ACLS meds if the doc was in the room. Hope this helps!!

Anne, RNC

When you were an LPN you could administer IV Push medications? Here in Ohio, LPNs are not allowed to give any push meds except a saline flush. So LPNs can in Kentucky? Always interesting how things vary state to state.

I was an LPN for 10 years and it was always tough for me because as a Paramedic I pushed all kinds of drugs but as an LPN I could not. Even now, starting as an RN, it will be weird because I am so used to standing protocol orders and now I have to make sure I have my order!

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Specializes in Neuro ICU.
We had a pt in SVT one night we gave 6mg adenosine, and HR slowed but sped back up but in A Fib with RVR. Doc on call asked for another adenosine dose. We told her no, you need to switch to cardizem or another med. Doc kept asking we kept refusing. Finally she ordered Cardizem bolus and drip. If we didn't know what drugs did what then there could have been a different outcome.

I think Doc was right. Usually with Adenosine it's 6mg then 12mg and then another 12mg and you have to slam it in and flush hard right behind it.

It's not uncommon for the first Adenosine dose to fail.

From there I would have expected electrical cardioversion.

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Specializes in Emergency, Pediatrics.
I think Doc was right. Usually with Adenosine it's 6mg then 12mg and then another 12mg and you have to slam it in and flush hard right behind it.

It's not uncommon for the first Adenosine dose to fail.

From there I would have expected electrical cardioversion.

But Adenosine is for a Narrow Complex Tachycardia NOT Atrial Fibrillation. The poster said the patient converted to an AFib. For that, Adenosine is not indicated. I would have gone for the Cardizem.

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Specializes in ER, TRAUMA, MED-SURG.
When you were an LPN you could administer IV Push medications? Here in Ohio, LPNs are not allowed to give any push meds except a saline flush. So LPNs can in Kentucky? Always interesting how things vary state to state.

I was an LPN for 10 years and it was always tough for me because as a Paramedic I pushed all kinds of drugs but as an LPN I could not. Even now, starting as an RN, it will be weird because I am so used to standing protocol orders and now I have to make sure I have my order!

Not as a rule, but in a code situarion if the MD is there we could give IVPs; the MD had to be in the room. We could give IVP Lasix, Bumex, Solumedrol, ect (but not narcs) by placing the syringe in the "mini infuser". Their theory was that if we used that, the LPN wasn't actually pushing the IV med - the pump was, but we were the ones drawing up the med, placing the syringe in the infuser and setting and starting it. I really didn't see a lot of logic to that - ...

But, in the code room, we as LPNs could give whatever was needed but the MD had to be there already. The unit I was working on at that time had 30 beds and 1 RN and the other nurses were all LPNs. I was glad to finish RN school and get my ACLS done.

Anne, RNC

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Specializes in LTC, assisted living, med-surg, psych.

I've never been ACLS certified but have certainly pushed my share of code drugs---D50, atropine, adenosine etc.---during emergencies. Honestly, the docs at the small-town hospitals I've worked in didn't care who was pushing meds as long as that person had a RN license and a pulse and knew how to follow instructions! :)

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