IVP vs Drip

[Matt8700]

Hello!!

had a question regarding medication administration. If yo have an order for a medication and it just says to be given IV, can you as the nurse choose to either give it as a push or a drip? Of course I know some meds must be an infusion, like antibiotics. However, what about meds like morphine, Benadryl, reglan, etc. Could you put them in a 50cc bag and let them run in over ten minutes instead of standing in the room and doing a two minute push? I guess I am just thinking of those crazy times when you want to medicate a patient for pain and don't want to rush, can you put their morphine and zofran in a bag and let it infuse? Just wondering.

[Julia77]

There is best practice, policy and nursing judgement to consider.

These are not always the same.

At my current hospital, I work in a contained ED, where we MIX our antibiotics. We use straight tubing in some situations (trauma and others) and use an IV medication manual for guidance on IVP versus mini bag, pump versus straight tubing, in-line filters, IV catheter size, administration time, dilution instructions and compatibility. Our pediatrics, kidney patients, and patients needing certain products (heparin drips, potassium, dilantin, blood) will ALWAYS be on a pump.

Some meds, only doctors will IV push, or the doctor will IV push the first dose.

I always use this book and then document, given per XXX manual, per policy, except for some drugs I give all the time and have memorized.

Best wishes,

Julia

[OregonER Murse]

Our computerized ordering system has two different orders for Reglan, one is 10 mg IVP and one is 10 mg IVPB in 50cc of NS over 20 min. Sometimes our docs will click the first one for IVP, however all the nurses in our ER will hang it in 50cc of NS over 20. It is pre-programmed into our infusion pumps. As a nurse who has witnessed more than one akathisia reaction (The I Gotta Get Out of Here NOW reaction), I would never give reglan or compazine IVP. Another hospital I have worked at actually has a policy that phenergan cannot be given IVP. If I get the order that says Reglan 10 mg IVP, I'll tell the Doc I'm going to give it piggyback,and I'll change the order. I have never had one tell me to give it IVP as it was ordered.

[KnitWitch, ASN, RN]

You only have to give someone the Reglan crazies once and I promise you, after that it will always go in a 50ml IVPB to hang.

Also, my chronic narc seekers and frequent fliers, your dilaudid/benadryl cocktail has been added to your 1000ml NSS infusion, as allowed by unit protocol. Enjoy.

[Anna Flaxis, BSN, RN]

You only have to give someone the Reglan crazies once and I promise you, after that it will always go in a 50ml IVPB to hang.

Also, my chronic narc seekers and frequent fliers, your dilaudid/benadryl cocktail has been added to your 1000ml NSS infusion, as allowed by unit protocol. Enjoy.

The one and only time I've seen the "Reglan Crazies", it was administered in a minibag, on a pump.