Is morphine compatible with TPN/lipids?

Aneroo, LPN · Nov 23, 2008

I didn't think anything was?

Then again, I'm not your best answer. We didn't do that in the ER, and I certainly don't in the school. LOL

SuesquatchRN, BSN, RN · Nov 23, 2008

Yes.

http://www.ajhp.org/cgi/content/abstract/42/5/1087

perfectbluebuildings, BSN, RN · Nov 23, 2008

Yes.
http://www.ajhp.org/cgi/content/abstract/42/5/1087

Thank you!!!

Roseyposey · Nov 23, 2008

.....

whipping girl in 07, RN · Nov 23, 2008

TPN is a high risk medication. You should have a dedicated port of the central line for TPN and not use it for any other medications if possible. You should not piggyback any medications into TPN or use that line for blood draw or IV pushes. Any time the system is broken or accessed it increases the risk of a blood infection due to the high dextrose content and bacterial growth potential of the lipid. There are some bacteria that are too small to be filtered out by the inline filter.

If you have a patient with a single lumen CL or port, try to start a peripheral for other meds or see if the CL can be exchanged with a multilumen CL over a wire.

SuesquatchRN, BSN, RN · Nov 23, 2008

That it's compatible doesn't mean giving it that way is good practice.

leslie :-D · Nov 23, 2008

we've done it in a pinch and wouldn't recommend it on a habitual basis.

yes, they're compatible but worry about risk of infection, esp where morphine can immobilize the gut.

leslie

madwife2002, BSN, RN · Nov 23, 2008

If in doubt ask the pharmacy.

allnurses Guide · Nov 23, 2008

We are never allowed to mix anything with TPN, it's got to be a dedicated line with nothing else infusing

tryingtohaveitall · Nov 23, 2008

In peds with limited access, we have always run meds with our Hal & IL. Haven't seen problems with it either. We change our Hal bags daily, Hal lines Q 72 h and our lipid lines Q 24 h.

ChristineN, BSN, RN · Nov 23, 2008

I have piggybacked meds into the TPN/lipids when necessary. I know it's not ideal, but if I only have one lumen, and they are compatible meds, I'd rather piggyback than turning off the TPN/lipids.