IV push

Fiona59 · Nov 19, 2008

I'm not sure what you mean by "IV push". The only nursing staff that is permitted to do IV push drugs (morphine, lasix, etc.) are in the ER and ICUs. The logic is that if they are that sick they should be in the ICU. In the last five years, I've only seen one IV push on the general floor and that was during a code.

IV antibiotics are usually hung as secondary lines on a pump and then the primary line kicks in and flushes. Saline flushes are routine q12h or qd.

AussieKylie · Nov 20, 2008

Thanks Fiona

So therefore when doing IV push for Normal Saline flushes can be done through IV Bung?

Well its just that I wasnt so sure what can be pushed through the IV bung because in Australia there are some IV ABs that can be pushed? So wasnt sure if the same in Canada.

kind regards & thanks :up:

Kylie

Valhalla_Pure · Nov 20, 2008

Hi there,

I think that this differs from hospital to hospital, and possibly ward to ward. I am currently finishing up a clinical rotation on an acute medicine ward at St. Paul's Hospital in Vancouver, BC. IV push is regularly performed by the RNs on the ward, and students (including myself) can perform this skill under the direct supervision of an instructor (provided they have learned this skill at their school already). I have not heard of antibiotics being administered by via push - I have only seen them via mini-bag. The most common drugs given by push on our ward are lasix and morphine.

Our hospital policy and procedure manual as well as the parenteral drug therapy manual outlines whether or not a drug can be given by IV push. It may also be written in the guide as "IV direct".

To sum up: it most likely depends what type of ward you are on and the needs of the patient's on those wards.

Pediatric Critical Care Columnist · Nov 20, 2008

Many antibiotics can be given IV push here, but only in the ICUs and the OR. We routinely give cefazolin, meropenem, ampicillin, gentamicin and a few others IV push in our ICU. The caveat is that they are given via central line in the most part, in high concentrations. Our parenteral drug manual will indicate whether it may be given IV direct by a specially-trained RN or if they need further dilution and a longer infusion time.

AussieKylie · Nov 20, 2008

Thank you so much for your input and help :) :yeah:

RNGrad2006 · Nov 20, 2008

I'm not sure what you mean by "IV push". The only nursing staff that is permitted to do IV push drugs (morphine, lasix, etc.) are in the ER and ICUs. The logic is that if they are that sick they should be in the ICU. In the last five years, I've only seen one IV push on the general floor and that was during a code.
IV antibiotics are usually hung as secondary lines on a pump and then the primary line kicks in and flushes. Saline flushes are routine q12h or qd.

Wow...I am currently working in the US but am planning on getting registered in BC down the road so love to read the Canadian issues.

In the US we do so much IV push on the floor that they are reluctant to have LPN's on the floor. In Arizona LPN's can't do any IV pump rate changes, IV pushes etc...

We do IV push for multiple drugs all the pain meds (mainly Morphine, Dilaudid, Toradol, etc...), Phenergan, Solumedrol, Decadron, Pepcid, Nexium etc... just to name a few. It would create a lot more ICU beds if we couldn't do IV push on the floor. I work in Neuro and the majority of our patients get IV push drugs.

RGN1 · Nov 20, 2008

It's the one thing I've found strange here - we're allowed only to push Narcan on our unit - after doing the course! Everythinog else goes up in 50 or 100 ml N/S. I don't have a major issue, except for furosemide (because you're adding more fluid that the pt needs to get rid of) & ondansetron (because if you're feeling sick you want instant relief.)

Fiona59 · Nov 20, 2008

Wow...I am currently working in the US but am planning on getting registered in BC down the road so love to read the Canadian issues.
In the US we do so much IV push on the floor that they are reluctant to have LPN's on the floor. In Arizona LPN's can't do any IV pump rate changes, IV pushes etc...
We do IV push for multiple drugs all the pain meds (mainly Morphine, Dilaudid, Toradol, etc...), Phenergan, Solumedrol, Decadron, Pepcid, Nexium etc... just to name a few. It would create a lot more ICU beds if we couldn't do IV push on the floor. I work in Neuro and the majority of our patients get IV push drugs.

I've heard about an RN from Arizona who moved up here. She treated the LPNs on her unit like they were beneath her. Multiple complaints to the manager and a chat for said RN.

RN's can't do IV push on the main floors of my hospital. We don't have any issues with it. Basically on a medicine, surgical or similar inpatient unit, the difference in scope of practice is very narrow. It all comes down to who starts the blood or TPN. Oh, and NG insertion. LPNs come out of college with that skill but the health authority determined it should be in the RN scope.

From reading other threads, it seems as if Canadians and Americans have different expectations when it comes to pain control. PCA and epidurals are common post op for some patients. Then it's on to IM morphine, demerol, or dilaudid (same for anti-emetics). Once you can keep fluids down, you get oral meds.