How long can IV push meds stay in a syringe?

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · May 9, 2011

I think you'd be better off asking a pharmacist. Some meds come from the manufacturer in glass, some in plastic. Like Tridill, some meds interact with common plastic. I doubt there's a single, simple answer toyour question.

lillystarrn · May 9, 2011

I think you're right. I work night shift and the pharmacist isn't there when I'm working, so I'm guessing the nurse supervisor is the one to ask? The only meds that I've drawn up and weren't able to give at the time because of a bad IV is pain medication, solumedrol, and nausea medications like zofran and reglan (I believe).

Five&Two Will Do · May 9, 2011

I think you're right. I work night shift and the pharmacist isn't there when I'm working, so I'm guessing the nurse supervisor is the one to ask? The only meds that I've drawn up and weren't able to give at the time because of a bad IV is pain medication, solumedrol, and nausea medications like zofran and reglan (I believe).

You could look at the package insert. Do you have a drug book. Most of the time it will mention if there is a huge risk of problems with a drug being held in solution for a extended period of time. It is a good habit of flushing IV's periodically during a shift to ensure patency. Hope this helps:)

casi, ASN, RN · May 9, 2011

I would think that an IV drug book would have the information about how long a med is good for.

ChristineN, BSN, RN · May 9, 2011

Solu-Medrol and Zofran shouldn't be a problem being pulled up for extended periods of time seeing how places I've worked where we gave high dose steriods (ie MS pts) or high dose Zofran (ie chemo pts) had those meds allready pulled up from pharmacy. Pharmacy would typically give us a 12 hr batch of meds at a time, so I would assume those two are good for at least that long.

imanedrn · May 9, 2011

I think you're right. I work night shift and the pharmacist isn't there when I'm working, so I'm guessing the nurse supervisor is the one to ask? The only meds that I've drawn up and weren't able to give at the time because of a bad IV is pain medication, solumedrol, and nausea medications like zofran and reglan (I believe).

If this is happening to you often enough, why don't you just check your IV site before drawing up the meds? It won't take you any longer, you just re-route your steps. I try to draw my meds up in front of patients anyway, so it works great for me.

morte, LPN, LVN · May 9, 2011

Yeah, a pharmacist would be the most helpful, I think. Perhaps leaving a message would be possible? and they could get back to you thru the super? and thank you for having the thougtfullness/critical thinking capacity!

GM2RN · May 9, 2011

I'm actually surprised that you aren't being trained to draw up meds at the bedside so you have another opportunity to check that you are giving the correct medication to the correct patient and to check for any allergies that they (or you) may have forgotten about. And I agree with checking the IV site first. These two things would solve your problem.

lillystarrn · May 9, 2011

I agree checking the IV site prior to drawing it up is a good idea and bringing the iv meds to the bedside. I'm going to try to do that from now on. I use to do that in the ER where I did my preceptorship since patients were in and out so frequently that it did help me to make sure I wasn't giving it to the wrong patient. I always do bring the MAR with me to the room, though, to make sure. I'm not sure why none of the nurses pull the meds up at the bedside, it's always done in the med room, so that's why I've been doing it that way. I am drawing up only one or two meds for one patient and then administering it to them (unless the IV site is bad...). If it's two meds, then it's usually a med for pain and one for nausea.

I feel like I'm still slow as far as giving meds because I am still trying to get in my "groove" and I'm bringing the MAR with me to the pyxis machine and to the patient bedside while I'm watching the other nurses seem to go by "memory." I know they've been doing this for a while and the patient ratio is low so maybe they're just use to everything.

There have also been times where it's been less than an hour of me either giving an antibiotic or another iv med to a patient's iv and then it "goes bad" all of a sudden. :uhoh3: Sometimes I feel like I have bad luck with IVs or that it was my fault the IV went bad, like I might have pulled on it somehow and caused it to go out of the vein. The place I'm at also has a lot of older patients, so their veins seem so fragile!

GM2RN · May 9, 2011

I agree checking the IV site prior to drawing it up is a good idea and bringing the iv meds to the bedside. I'm going to try to do that from now on. I use to do that in the ER where I did my preceptorship since patients were in and out so frequently that it did help me to make sure I wasn't giving it to the wrong patient. I always do bring the MAR with me to the room, though, to make sure. I'm not sure why none of the nurses pull the meds up at the bedside, it's always done in the med room, so that's why I've been doing it that way. I am drawing up only one or two meds for one patient and then administering it to them (unless the IV site is bad...). If it's two meds, then it's usually a med for pain and one for nausea.
I feel like I'm still slow as far as giving meds because I am still trying to get in my "groove" and I'm bringing the MAR with me to the pyxis machine and to the patient bedside while I'm watching the other nurses seem to go by "memory." I know they've been doing this for a while and the patient ratio is low so maybe they're just use to everything.
There have also been times where it's been less than an hour of me either giving an antibiotic or another iv med to a patient's iv and then it "goes bad" all of a sudden. Sometimes I feel like I have bad luck with IVs or that it was my fault the IV went bad, like I might have pulled on it somehow and caused it to go out of the vein. The place I'm at also has a lot of older patients, so their veins seem so fragile!

I understand about feeling like you are slow and wanting to use whatever tricks you can to speed up. I used to do the same as you and draw them up in the med room, but let me share with you a couple of tales that made me change my ways.

Trying to become faster, while a good thing, can also cause you to make mistakes. When I was new in the ED, I once gave a patient a medication prescribed for migraines (the name eludes me at the moment) which was supposed to be given SQ. I knew this when I drew up the med, but in my haste, I gave it IVP at the bedside. This med has the potential to cause very dangerous side effects when given IVP. Fortunately for my patient and myself, the patient suffered no ill effects.

Another time, we had just changed from 30 mg vials of toradol to 60 mg vials of toradol. I knew I would need to be careful when giving this drug IVP since I was used to giving the entire vial, but now would need to make sure I gave only half of the dose when giving it IVP. Careful though I was, I was again in a hurry and gave 60 mg of toradol IVP to a patient. Again, no ill effects to patient, but I felt horrible that I made another mistake of that nature. Now, I never draw up meds in the med room, but instead, take the medication and a paper copy of the MAR to the bedside.

Another reason to draw at the bedside is patients will sometimes refuse narcotic pain meds. Once drawn up, you can't prove to another nurse what is in your syringe, and could have trouble getting someone to waste that medication with you. Even if you do, you will have unnecessarily wasted a medication.

Finally, drawing at the bedside gives you an opportunity to catch any allergy mistakes made by the doctor or patient. I have had docs order meds to which the patient had already stated an allergy and caught it when asking the patient before drawing up the med. I also have asked a patient at the bedside if he/she is allergic to any medications and had them suddenly remember that they had an allergy that was previously forgotten. Again, this results in not unnecessarily wasting medications.

As for IVs, I think that is something that you will learn to master given enough time. Looking to experienced nurses (the good ones anyway) to model yourself after and for tips is a good thing, but be careful not to compare yourself to them in terms of time management while you are still new to the nursing experience or you will become frustrated. Just try to relax and realize that you WILL get better/faster, but it will take time, and you need to allow yourself that time. Good luck!

imanedrn · May 9, 2011

I feel like I'm still slow as far as giving meds because I am still trying to get in my "groove" and I'm bringing the MAR with me to the pyxis machine and to the patient bedside while I'm watching the other nurses seem to go by "memory." I know they've been doing this for a while and the patient ratio is low so maybe they're just use to everything.

Don't get in that habit. As nurses, we do a lot of things that we just shouldn't because it's easier. Even though I "know" what meds I'm giving to my patient, even it's just one, I try always to bring the MAR with me to the Pyxis and bedside. Get in the habit of doing that, and it will become so second nature, that it will become one less thing for you to worry about.

It sounds like you're just frustrated with being new. Take a few deep breaths and pat yourself on the back. :yeah:

You're open to suggestion, and that's one of the best things you can do as a nurse -- experience, intermediate, and new, alike!