need help with IV med

[Navarre]

I'm a nurse intern and am uncertain about how to dilute meds. For example, if I have a 2 ml vial of a med and want to dilute it in 8 ml of NS, do I draw up the NS or the med first and do I have to inject air into the 2 ml vial(I thought I read somewhere that the med could splatter everywhere if you inject air)? If someone could please tell me step by step how they do this I would really appreciate it. Thanks.

[RN2B07]

Ok...first I always draw up the NS first because you will contaminate the vial if you draw up the med first. Certain meds like morphine and dilaudid come in long, skinny vials, and injecting air is a no-no. Then draw up the 2ml or whatever of the medication.

[natsfanrn]

We have those prefilled 3- and 10-cc NS syringes in our med room. When I give an IV push, I draw up the med first (I inject air if it's a regular vial, don't inject if it's a skinny tube like dilaudid or morphine). I use a twin-pack cannula (one end sharp; other end plastic safety), using the sharp end to draw the med (I've seen those plastic cannulas break off when puncturing the diaphragm of vials). Then I cover the sharp end, flip over to the safety cannula and insert that into the prefilled syringe and push the NS into the med. Hope that makes sense...

[Daytonite, BSN, RN]

I draw up the medication first. Just suck it out of the Carpuject vials if that is where you're taking it from. Sometimes you have to exert a little pressure on your plunger to get the med out. Then, I add whatever I'm diluting it with.

[crb613, BSN, RN]

We have the pre-filled syringes also (10 ml's). If I need 2ml's of a med diluted w/8ml's NS. I just waste 2ml's of NS then draw up the 2ml's of the med. I always check that it was 10ml's when I start, 8ml's when I waste, & 10 ml's when I am finished. This is how I was showed to do it if I am wrong......Please correct me!

[jjfadd]

We have the pre-filled syringes also (10 ml's). If I need 2ml's of a med diluted w/8ml's NS. I just waste 2ml's of NS then draw up the 2ml's of the med. I always check that it was 10ml's when I start, 8ml's when I waste, & 10 ml's when I am finished. This is how I was showed to do it if I am wrong......Please correct me!

I do that too, but a while back (last year) I recall being informed by our pharmacy that we were to "manually" draw up our own syringes to dilute. A few weeks ago I followed up with the pharm. and they said it was ok to use the prefilled syr's... whatever is faster and more efficient works for me.