Ok, I know this is a stupid/basic question, but I just would like advice. We used to have the nice vials of narcotis with the measure on the side so you could see how much you pull up (like, if patient is to get 2mg and it is a 4 mg vial, you could see on the side that you pull of .5 ml) but now we just have these vials with no measurements. I used to pull up the meds into a 10cc pre-filled flush syringe, but now I can't get an accurate measure of pain medication doing this. We don't have little vials of NS, so I can't pull up the med into an empty 10cc syringe and then pull up NS.
Anyway, how do you guys pull of narcotics and ensure you are giving the correct dose - it's especially hard with the patients who only get .5 Dilaudid (which is only .25ml!)
In our hospital, we once again have no 1 mg/mL dilaudid d/t a 'national' shortage. We only have the 2 mg/mL strength. The biggest issue is when doctors order 0.2 mg...that is 0.1 mL of the med. Pretty much impossible to draw up even with a 3 mL syringe...a TB syringe has to be used. I draw up with the TB syringe and inject it into a 10 mL flush.
There used to be a 1mg/ml of Dilaudid vial?! I started in the hospital last November and I have always seen 2mg/ml. I can't wait until the days we are back to the 1mg/ml! My nursing life would be complete!
There used to be a 1mg/ml of Dilaudid vial?! I started in the hospital last November and I have always seen 2mg/ml. I can't wait until the days we are back to the 1mg/ml! My nursing life would be complete!
I have been a nurse for 3 1/2 years and have never seen 1mg/ml dilaudid...that is one long shortage!! Lol
We have these. I use a 1 ml syringe to pull up the desired amount, inject the drug and follow with a 3 or 10 ml flush. Why are you diluting? Just curious, not saying it's wrong.
I agree that if you are going to dilute, you need to request the small vials of saline.
I also prefer to pull up the entire 1 ml from the vial and waste into the trash can until I reach my dose of say, 0.25 mls. Don't like to add all those meds to the water supply.
I do wonder why docs order these ridiculous low doses of dilaudid. If the drug comes in 1mg/ 1ml vials it seems to me that should be the normal dose. It was in the ED. I guess people are scared of narcotics and prefer to have the nurse deal with a patient whose pain is not in control...
We have these. I use a 1 ml syringe to pull up the desired amount, inject the drug and follow with a 3 or 10 ml flush. Why are you diluting? Just curious, not saying it's wrong.
It is easier to push at a slow speed in a 10ml syringe, it's hard to push 0.25ml over 2 minutes!
I do wonder why docs order these ridiculous low doses of dilaudid. If the drug comes in 1mg/ 1ml vials it seems to me that should be the normal dose. It was in the ED. I guess people are scared of narcotics and prefer to have the nurse deal with a patient whose pain is not in control...
Some people are sensitive to narcotics and cannot handle 1mg of Dilaudid. I agree sometimes the MDs don't order a high enough dose but I've seen my fair share of snowed patients after getting 1mg.
It is easier to push at a slow speed in a 10ml syringe, it's hard to push 0.25ml over 2 minutes!
Some people are sensitive to narcotics and cannot handle 1mg of Dilaudid. I agree sometimes the MDs don't order a high enough dose but I've seen my fair share of snowed patients after getting 1mg.
Ok. I work in high acuity settings with constant monitoring and so on, so we don't dilute. We just push and flush. Our patients are usually not narcotic naive, which also makes a difference.
I do think its better to dilute in 10 mls if you're going to. I've seen nurses dilute 1 mg of dilaudid in a 50 ml bag of ns and run it on the pump! How much pain med do you think the patient really got? Not enough ;-)
I do think its better to dilute in 10 mls if you're going to. I've seen nurses dilute 1 mg of dilaudid in a 50 ml bag of ns and run it on the pump! How much pain med do you think the patient really got? Not enough ;-)
This is a problem on our floor. A while back there was an "incident" and now no one pushes anything. It is ridiculous, we are a post-op floor! I push it if I can, no reason not to and the patient appreciates it!
PediLove2147, BSN, RN
649 Posts
There used to be a 1mg/ml of Dilaudid vial?! I started in the hospital last November and I have always seen 2mg/ml. I can't wait until the days we are back to the 1mg/ml! My nursing life would be complete!