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Discussion

Diluting your IVPs??

Met a nurse the other day that dilutes everything.

My question is................

Say you have to give Dilaudid 0.5mg IVP and you are supplied with 2mg/ml ampules. So you draw up the one ml and inject it into 9ml of a NS syringe giving you a 0.2mg/1ml concentration. My question is: How do we know that the medication is evenly distributed throughout the NS so you are in fact only giving 0.2mg/ml?

I'm sure there's some scientific something or another that I missed in school that can explain this. Someone please enlighten me.

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First, you draw up the entire vial into a syringe and waste all but your dose needed. You take the rest of the syringe and dilute it into a 10ml syringe.

Give all of the larger syringe.

We dilute drugs like this in NICU and peds all the time. You mix it

in the syringe or vial, this is the solution. Figure out your dose based on what the solution is. Draw it up in a syringe and discard what is left. It's just less concentrated.

  • Author

Good point....my example is from a PACU where nurses commonly draw up an entire vial and give boluses as needed instead of wasting for every administration due to the higher volume of IV narc pushes immediately post-op. The wasting occurs after the patient's pain is controlled.

WHAT?! So they have like 3-4 full syringes of narcotics and benzos in their pocket and have to keep track of which pt they belong to??!

Forget that! I like my license where it is.

  • Author

No no no...just one syringe at a time. Fentanyl is our first-line drug so I'll have a syringe with 100 mcg in it and give 25-50 mcg boluses every 10 minutes as needed. If I'm done with that drug for that patient or if I switch drugs I'll waste what I have before continuing.

WHAT?! So they have like 3-4 full syringes of narcotics and benzos in their pocket and have to keep track of which pt they belong to??!

Forget that! I like my license where it is.

In pacu, we typically only have one pt at a time.

Met a nurse the other day that dilutes everything.

My question is................

Say you have to give Dilaudid 0.5mg IVP and you are supplied with 2mg/ml ampules. So you draw up the one ml and inject it into 9ml of a NS syringe giving you a 0.2mg/1ml concentration. My question is: How do we know that the medication is evenly distributed throughout the NS so you are in fact only giving 0.2mg/ml?

I'm sure there's some scientific something or another that I missed in school that can explain this. Someone please enlighten me.

It is. How do you know? Same way you know that a drug mixed in a 50 or 100 ml big is distributed.

Something to do with diffusion,

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