Med error? help im going to loose ky mind thinking about this!!!!!!

[avenellpn82]

Ok I'll try to be short. So I have been giving rochephin with lidocaine IM for the past four days its two grams. Now today the last day of the ABT I go to my charge nurse RN to get a 3 ml syringe she tells me I should use a 5 ml. I thought I was wrong all along giving this patient too little of a dose. Now when I looked at the syringe I felt that something was wrong but again my charge nurse told me it was correct so I gave the injection. When I came out of the patients room the DON asked me why did I look so nervous so I told her I just gave a patient an IM with a 5 ml syringe and she is so frail that it just scared me a little. Soooooo now how it gets to a med error......... She asks me what med it was and some other questions about the patient then she says what's the most an IM should be I replied 2 ml then she says well that's a huge med error u gave her dble the dose of lidocaine. Now even though the charge nurse told me to do this I now feel so damn stupid because I know that if u feel unsure about something u should check other resources and btw to make it worst I always have my lipincott clinical skills book :-(

Now the question...... This is my first med error what should I expect? I am freaking out.

[Isabelle49]

A quick search indicates that 2.5 ml is the max for injection to dorsogluteal of adult.

[linearthinker, DNP, RN]

Well I was still wrong, lol. I thought it was 2.

[SeeTheMoon]

because according to the order it was to be 2 mls total after reconstituting with the lido.

How could it be 2ml total if (per your 2nd post) it was "2g plus 5 ml?"

I'm so lost...

[Old.Timer]

This thread is hysterical. I feel like I am in the twilight zone. :)

[sweetsleep28]

The dr at my old facility loved to prescribe Rocephin 1gm IM for 3 days. The vials we had came with 1 gram of Rocephin to which the nurses at my old facility including myself reconstituted with 1.1 of lidocaine in a 3ml syringe.

Any chance you are working in LTC facility OP? We did not place peripheral lines in my old LTC facility, if a resident needed to receive fluids, long term ATB therapy meaning more than 3 days of a med we always had Midlines placed. So that's my educated guess. So I personally understand why she may have been giving the Rocephin IM instead of IV. OR I could be totally off in left field somewhere

[Mulan]

Years ago I learned 5 cc.

I have a book in front of me right now that says 1 to 10ml.

I know of a nurse that gave a 10 cc injection in one butt and a 10 cc injection in the other butt one time, doc said it was fine, I think it might have been mag sulfate.

Looking on the internet (how inaccurate is that) I see varying numbers, 3, 4.

[Mulan]

Sometimes people post and make such definitive statements and a lot of the time they are not correct.

[tyvin, BSN, RN]

It's 2.5 ml not 2 ml that is acceptable for a deep muscle injection.

[jadelpn, LPN, EMT-B]

If you look at the pamplet that comes in the individual dose box of rocephin, it tells you how much lido to add to reconstitute. If it comes out to 5ml's (which escapes me, but I don't think it ever came out to that much) it should be put in 2 different syringes, for 2 injections. Often we will do IM rocephin when IV access can't be easily obtained--so patient doesn't want one, or patient is declining an IV outright. And I always give rocephin in the largest muscle I can, and that is usually not the arm. And always check with the pharmacist, if there is a question. Depends on your facility what happens when you have a med error--but you did check the dose with another nurse. Good luck

[xtxrn, ASN, RN]

One source says 5ml/single injection (not happening with this RN), the other says 3ml/single injection - in a large muscle.

Personally, I wouldn't give more than 3cc/injection to anybody who wasn't very well padded, and if needed, cut it back; you can't hurt them with less volume...too much (which can be very subjective and individualized) can be painful beyond plain injection site soreness. Why chance it. That being said, what was the original question?

http://www.drugs.com/cg/how-to-give-an-intramuscular-injection.html

http://www.brooksidepress.org/Products/Administer_IM_SQ_and_ID_Injections/lesson_2_Section_1.htm

[madwife2002, BSN, RN]

https://allnurses.com/general-nursing-discussion/im-injection-help-128110.html

previous debate

[PureLifeRN]

I have had to give myself Rocephin IM shots with lidocaine when I was pregnant, living overseas in a third world country. It was probably about 3-4ml. Not sure if thats the norm or just where I was living. It hurt like hell though!