Is Heparin and Mag compatible

darkbrownhairgirl · Mar 28, 2005

as far as I know, you should not incorporate anything to hep infusion.

Also if they are would you still start a new IV if you have orders to run both of them at the same time..........or would you piggy back the heparin to the magnesium..........

Oders where for 25,000units heparin IV to run at 9cc/hr

Magnesium in D5% (gosh forgot how many ml of D5% 100ml I believe.....can not remember now.............how would you run this

I guess they are compatible cause the preceptor ran it together.........but another nurse told me they where not compatible................the patient complained of burning so the preceptor slowed the rate it was 100cc/hr for the mag as the primary and 9cc/hr for the secondary to run concurrently would you have done it this way

With pt complaint of burning and site inspected it was not infiltrated or swollen but felt burning sensation so it was slowed down to 50cc/hr for the Magnesium and next shift notified to watch site for any changes since this was run at the end of the shift.............pt given mag cause he had several episodes of nonsustained VT..............mag level low..............

I guess I left that shift wondering if the burning was from running heparin and mag together or from the original rate of 100cc/hr for the mag ........I am a newbie so needed to know from experiences nurses what you would have done with those orders

To start another peripheral line ............the patient would need one soon anyway cause it was inserted 3/22 and it was 3/25............or keep the heparin in the 3/22 line and start a new one for the mag ...............just curious as to what would have been the best options .........did my preceptor pick the best option to run them both concurrently............pigging backing the heparin

zambezi, BSN, RN · Mar 28, 2005

I do not know if heparin and mag are compatible...however, if you don't know and are going to be administering a mediction, it is best practice to find out first...you can either look it up in an IV infusion book/drug book or call your pharmacist.

I would have called pharmacy to verify- if compatible, I would have run them together, if not, you would have had to start a new line. In this case, since the patient needed a new IV anyway, I would have just started another line, given the mag, flushed the line, switched the heparin over to the new site and dc'd the old IV.

Heparin is compatible with some medication (such as nitro). Again, if you don't know, look it up or call the pharmacist.

As for the burning, I would have just slowed the rate and possibly added a carrier fluid (NS) to help dilute the mag.

angelique777 · Mar 28, 2005

I do not know if heparin and mag are compatible...however, if you don't know and are going to be administering a mediction, it is best practice to find out first...you can either look it up in an IV infusion book/drug book or call your pharmacist.
I would have called pharmacy to verify- if compatible, I would have run them together, if not, you would have had to start a new line. In this case, since the patient needed a new IV anyway, I would have just started another line, given the mag, flushed the line, switched the heparin over to the new site and dc'd the old IV.
Heparin is compatible with some medication (such as nitro). Again, if you don't know, look it up or call the pharmacist.
As for the burning, I would have just slowed the rate and possibly added a carrier fluid (NS) to help dilute the mag.

The precetor did look it up and he was the one giving.........its just that a more experienced nurse say they should not run together and was just curious what other nurses practice and what they would have done

thanks for your reply each reply gives me some insight as to what other nurses know thanks

UM Review RN, ASN, RN · Mar 28, 2005

The precetor did look it up and he was the one giving.........its just that a more experienced nurse say they should not run together and was just curious what other nurses practice and what they would have done

The situation often becomes sticky when there's a clash between what the books say and what the hospital policy says.

At my hospital, we do not run anything with heparin OR mag and each would run from a pump. Exceptions--such as a patient who had unsuccessful attempts to start that second IV line, yet needed the meds asap--would have to be cleared with Pharmacy.

angelique777 · Mar 28, 2005

The situation often becomes sticky when there's a clash between what the books say and what the hospital policy says.
At my hospital, we do not run anything with heparin OR mag and each would run from a pump. Exceptions--such as a patient who had unsuccessful attempts to start that second IV line, yet needed the meds asap--would have to be cleared with Pharmacy.

That clarifies a lot for me .......cause I did not mention I worked on an oncology unit before and in the back of my mind I could have sworn that nurse said she does not run anything with heparin ...............she had yrs of experience and that was my recollection but did not understand why the discrepancy b/w the nurses now I see that hospitals have different policy on why they would not run them together :confused: ..........does any one know why that policy is in place it must be a saftey reason for them not to run together......can some one explain

by the way thanks ANGIO for clarifing my previous question for me that helped

:)

zacarias, ASN, RN · Mar 29, 2005

Heparin is compatible with a TONS of drugs but it is definitely appropriate to have a dedicated line for heparin especially if it's hospital protocol. In a pinch of course you have some flexibility.

Mag sulfate, for instance three grams should run for about four hours.

Pill Hoarding Hussy · Mar 29, 2005

yes they are... according to my facility's guidelines. IMHO, it is always best practice to look it up or call pharmacy yourself, not just take someone else's word for it- no matter how much experience they have. i don't think anyone would ever purposely give you bad info on something like this, but we all forget/get confused/have our particular preferences. when in doubt, check it out- for yourself.

RNCENCCRNNREMTP · Mar 29, 2005

An additional resource is Epocrates on your handheld. Using the King Guide as its reference you can look up IV solution and IV site compatability on hundreds of IV drugs.

angelique777 · Mar 29, 2005

yes they are... according to my facility's guidelines. IMHO, it is always best practice to look it up or call pharmacy yourself, not just take someone else's word for it- no matter how much experience they have. i don't think anyone would ever purposely give you bad info on something like this, but we all forget/get confused/have our particular preferences. when in doubt, check it out- for yourself.

I was with my preceptor when he looked it up...I saw the list of compatability for IV ..I guess I do not always believe what I read on paper either stuff can change from when last posted but your right that was the first step and good advise ........my confusion was why nurses with more experience felt they should not go together............when nurses with more experience express something I listen. So even though the paper said they could I doubted it cause of what the nurses with more experience said. It is good to look at compatability lists that is also first no doubt but my confusion lie in the discrepancy of opinion amongst nurses and I think that was addressed when Angio stated that often time hospitals have there own policy as to how they want certain solutions to hang and that helped clarify why the difference in opinion.

thanks again for your post

hopefully someone will know why some hospitals do not want to hang these two together even though compatible

Pete495 · Apr 4, 2005

Magnesium and Heparin are definitely compatible. I run them together on a regular basis. You'd be surprised that heparin is actually compatible with a lot of things

Anyway, How much Mag were you giving? The typical dose is 2g in 50ml of d5w, and you can only give that over 2 hours. So you may have been running it too fast, and magnesium will burn at the site if run too fast.

I don't think the problem with heparin is its compatibility so much, but it is much safer to flush a free line than give a patient a flush of heparin or withdrawl blood every time you need to give something else. Plus, if you are running heparin, there is a higher chance for other complications as well, so it's just safer to have a second line. However, I have had patients with just a line of heparin for lack of another vein to poke.

brittkay70 · Mar 9, 2006

we run mag and heparin together - i would have piggybacked the mg in with heparin as my primary - my guess is the burning was coming from the mag which was running to fast (2gm in 100ml over 1hr) I usually run 1gm over 45 min at max - on some pt.'s i have even had to run NS at a KVO rate like 10 or 20ml to dilute the mag - also i always use a pump with mg although i have seen some RN's run it on a dial-a-flow. but i guess in your case that point in mute b/c of course the heparin was on a pump