IV Morphine Push

[Sweetie2005]

How many mL are actually in the primary IV tubing at any time? I gave some IV Morphine (2mg/mL) through a carpuject through a line running normal saline at 20mL an hour. If 2mg was pushed over 10-15 seconds in the closest port running into a picc line, how long until the patient received the dose?

[RaNda]

I normally flush the line after pushing an IV med if the rate is only 20ml/hr. I believe the volume of most IV tubing is 20-30ml. I normally flush slowly over 1-2 minutes so that I know that my patient does not have to wait for the med to be delivered. This also ensures that the port is clear for any other IV meds to be administered.

[solneeshka, BSN, RN]

I normally flush the line after pushing an IV med if the rate is only 20ml/hr. I believe the volume of most IV tubing is 20-30ml. I normally flush slowly over 1-2 minutes so that I know that my patient does not have to wait for the med to be delivered. This also ensures that the port is clear for any other IV meds to be administered.

If your IV tubing is 20-30mLs, that is some LONG tubing! PICC lines are 3 mLs. Seems very surprising, they seem like they ought to hold more. But the lumen is very, very small. This is why it's so important not to pull back with too much gusto when drawing blood out of a PICC, otherwise you'll just collapse the lumen (from too much suction) and you won't get anything, or you'll hemolyse what you do get. Anyway, if a PICC only holds 3 mLs, you can imagine how little a PIV holds.

[AbeFrohman, BSN, RN]

Usually about 6 cc between closest port and patient if I remember right. Just flush it and slam it in there. 2mg of morphine is practically nothing. As a crna, I give 10 to people without causing apnea on a regular basis.

[LouisVRN, RN]

I know for sure that our primary sets hold 5 cc. If you administered it into the closest port to the patient, and it was 2mg/1 ml, and you didn't dilute it, it would probably reach the patient in 5-10 minutes.

[solneeshka, BSN, RN]

Sorry, I read the OP incorrectly. I experimented with this once, but that was flushing from the top of the tubing (from where the bag would hang. It took about 15 mLs to start coming out the patient end. From the port closest to the pt, then, I would think 5 mLs is a good estimate. I always push slowly regardless of concerns about apnea because if the pt gets a rush that may either frighten them or they might like it, and I don't want either of those things to happen. ALWAYS flush after you give a med, so that whatever gets given through that port next doesn't cause a reaction. S-A-S can save your license (saline - admin the drug - saline).

[JStyles1]

why not just flush the line with another syringe right after giving it to make sure it goes in. not flushing lines with another syringe immediately after med administration is very risky for incompatible meds and precipitation

[iluvivt, BSN, RN]

PICCs actually have a very low priming volume between 1/2 ml to 1 ml..this varies by brand and gauge and amt trimmed of course. Priming volumes on non-microbore tubing primary tubings also varies but most are between 10-15 ml from the drip chamber to the distal end. A safe way to administer any IV push med is to give the flush volume at the same rate as the push med...if you are worried that you will not get a good pulsatile flush....give a second NS flush after you give the first as described b/c if you have a low volume IV push med it could still be sitting in the tubing and/or the PICC or CVC and then you could push it in too fast...if you do it this way you never have to worry about volumes too much.