Mixing multiple iv drugs in one syringe

Gompers, BSN, RN · Jul 13, 2005

Separate syringes for each IV med. The compatibility charts will tell you what meds and IV solutions are compatible, so you know if you can just run them into the same IV line or not, or if you need to flush the line between meds. But it's much safer to just draw each med up separately in it's own syringe. Besides, the patient doesn't feel each needle being stuck into the IV tubing, so why not use separate syringes?

Now, if it's an IM injection, and you only want to stick the patient once, then you can look into compatibility for that kind of thing. Even then...draw each med up separately in it's own syringe, then squirt them all into a larger syringe after you've checked that they are each correct. It's safer to measure each one individually first rather than to draw them all up into the same syringe.

candyndel · Jul 13, 2005

Never mix IVP meds in one syringe. IM, yes. IV, no.

Also, dont ever feel stupid asking questions. I'd feel more stupid not asking and getting it wrong!!

UOTE=student_nurse_07]Hi, all. I had a nagging question that I never got the courage to ask in fear that I might appear stupid or lazy. I'm sure I can get the right answer here from ICU nurses.

When pushing IV meds, can you mix different drugs together in one syringe and push all at once or do you have to get seperate syringes for each meds? I know there is the compatibility chart I could refer to but I'm not sure what the compatibility is used for.

I'm so glad I found this website so I could ask any stupid(?) question! :rotfl:

Thanks in advance for any advice.

rehabhereIcome · May 21, 2008

Now, if it's an IM injection, and you only want to stick the patient once, then you can look into compatibility for that kind of thing. Even then...draw each med up separately in it's own syringe, then squirt them all into a larger syringe after you've checked that they are each correct. It's safer to measure each one individually first rather than to draw them all up into the same syringe.

How do you squirt 2 individually drawn up meds into a larger syringe?

Never heard of that.

elizabells, BSN, RN · May 21, 2008

Pull the plunger out of the big syringe, put the blue tipcap back on, squirt the meds in, then put the plunger back in as far as it will go, turn the syringe over (so all the air is at the top, at the tip), and remove the tipcap - you may have to hold pressure on the plunger while you do this. You'll then be able to advance the plunger up to get all that extra air out of the syringe. It's hard to describe, but it makes sense once you do it. Just be careful not to squirt the meds everywhere by pushing too hard on the plunger!

You can also pull the plunger back just a bit more than the volume you need, and put needles on your smaller syringes, and CAREFULLY insert the needle into the tip opening and squirt them in that way. Probably not exactly kosher in terms of safety, but you're less likely to accidentally misjudge the pressure and squirt your meds everywhere than using the first method.

rehabhereIcome · May 21, 2008

I believe it to be a real technique just never heard of it! LOL!

I was trying to imagine myself doing it(butter fingers here!) and I liked the second idea a little better. I understand how to do it now.

thanx

meandragonbrett · May 22, 2008

You will learn that some things can be mixed and that you will do it on a routine basis to save supplies. For instance Morphine/Dilaudid/phenergan are routinely mixed and given with one syringe. If you ever mix diazepam with anything you'll quickly learn that it has an attitude all of its own. Good luck!

WolfpackRed · May 24, 2008

It can be done, and I have done it once. I used micromedex to check compatibility; they have an option to determine syringe compatibility under the "IV compatibility" tab.

AbbeyT · Jul 27, 2012

It's not a stupid question. On the one hand, I agree that pulling them up in separate syringes is usually best, especially if you're a student. I'm a new nurse and I still pull in separate syringes just because I'm paranoid. However, on our floor there are several drugs that we routinely give that are compatible and can be mixed together & a lot of the seasoned nurses do that to save supplies. Like wolfpack said, there's usually a program like micromedex (which we have too) that allows you to check for compatibility before mixing. :) There's no such thing as a stupid question!

07302003, ASN, RN · Jul 28, 2012

Drugs given together for sedation, like Ativan and Morphine, in the ICU for vented patients, I generally put in the same syringe with saline. But other common IVP drugs, like protonix, solu-medrol, lasix, famotidine, I always give in their own syringe. And vaso-active drugs like lopressor, hydralazine, are ALWAYS in their own syringe and pushed slowly.

No question is stupid - you can never ask enough questions to make sure you're giving meds safely!

detroitdano · Jul 28, 2012

Why not mix if you know the two can be? I commonly mix up Morphine and Ativan. Just get a 10 mL flush, kick out 2 mL's, draw up your drugs and push. It might work fine either way, diluting or not, but I just feel silly pushing 1 mL. Kinda like giving 2 units of insulin, feels like you're not even pushing the darn plunger.