Morphine vial dose...HELPP!!!!!

[Marie1205]

Is there such thing as Morphine 1mg/ml in the carpuject syringe?? HELP!!

[vanburbian]

Never seen it myself, doesn't mean it's not out there somewhere though. Smallest I have seen is 2mg/ml

[Vectrexevo]

I've never seen such a little amount in one

[MomRN0913]

ditto

[Altra, BSN, RN]

Why the "HELPP!!!!!" ?

[tyvin, BSN, RN]

Are you sure it's not 10mg in a 1 ml carpuject... that's quite common. Got to watch those decimals.

[Marie1205]

Here's the story:

Disclimer: I'm a new grad finishing my third week on a med/surg floor.

I got an order for morphine 1mg IV now. So I pulled the med from the Pyxis, drew the med at the bedside (diluted in NS), and threw the vials in the sharps (first instinct). Charted it...done and done.

The next day, I have the same pt. I printed a new prn mar sheet (with the now dc'd morphine "now" order. I see on the mar: morphine 2mg/ml, give 1mg. If this was the case, did I throw away the other 0.5 ml without realizing it??? Without a witness???

What made me question the dosage availability (1mg/ml) was that: I saw an order for on the mar: zofran 2mg/ml, give 4 mg. But when I pulled the med from the Pyxis, the availability was a 4mg/2ml vial instead of the said "2mg/ml" in the mare.

What I'm HOPING is that there was also a discrepancy with the dosage availability and what was written on the mar. Makes sense? I'm HOPING that what I pulled was indeed a 1mg/ml syringe, and not a 2mg/ml syringe. Otherwise, without a witness, it will seem like I took the other 0.5 for what ever reason.

I asked my best friend, another RN..and she says that the Pyxis would normally prompt me for a witness, but this was not the case. I've never witnessed a med yet, so I don't know how that process works.

I have a habit of keeping my brain sheets even long after I don't have a pt, so I still have my brain in my locker at work. I don't go back work until Monday, so I will be stressed out all weekend...unless my manager gives me a call first :/

The more I think of it, maybe the other said: give 2mg now, then 1mg q2h prn?? I don't know!!!!! I'm in panic mode! I'm a newbie and I already made a mistake!!

[CompleteUnknown]

I haven't seen 1mg/ml either. Was this an adult patient? I know this isn't the point, but 1mg morphine seems like such a small dose!

[diva rn, BSN, RN]

I've worked in ICU and Hospice for years...(meaning 2 areas where a lot of Morphine is given) and I personally have not seen it in a dose of 1mg/ml...the usual in a stock pyxis carpujet is 2mg/ml.

[vanburbian]

The pyxis won't ask you for a witness until you actually enter the waste amount. You need to correct this, because otherwise, it "could" look like you walked away with some amount of morphine.

Pharmacy generally audits all the narcs given, and if you gave half a vial, but checked out a whole vial, they will red flag it as a missing dose.

Or, it could look like you gave the wrong dose.

In either case, you should call a charge nurse and ask them how to correct the error, and let your manager know.

[tyvin, BSN, RN]

Well if that's the case then unless you wasted half of it you gave over ...

[AJPV]

I would call the manager first thing in the morning. Even if you messed up, the fact that you're calling them and not waiting for them to call you will tell them you're not hiding anything.