Lasix IVP IV rate vs PICC rate

[mrmedical, ASN, BSN]

Just something can jumped into my head today about pushing Lasix; do you change the speed at which it's administered depending on the site of entry ie peripheral IV versus a PICC or central line?

For example 40mg Lasix usually over 2 minutes in a peripheral IV, could one go faster in a central line due to the the faster dilution of drug in system circulation without increasing risk for side effects like ototoxicity?

Thoughts? Not trying to be reckless in giving meds, the safe ways is obviously to go slow, but just out of general curiosity.

[FlyingScot, RN]

Lasix should be pushed no faster than 4mg/min regardless of the type of line you are using.

[AggieNurse99, BSN, RN]

Unless specific reason exist for a fast push, i.e. adenocard, you should always go over at least 2 min, regardless of the line. My first day in nursing clinicals, for whatever reason, a pt had a bedside echo with contrast of some sort. This pt had a PIV in the right hand and the primary nurse, myself, and my instructor were stunned that in less than 5 seconds the first 'push' of contrast had already made it out of the heart and into circulation. I wish I remembered what the test was.

[guest042302019, BSN, RN]

Unless specific reason exist for a fast push, i.e. adenocard, you should always go over at least 2 min, regardless of the line. My first day in nursing clinicals, for whatever reason, a pt had a bedside echo with contrast of some sort. This pt had a PIV in the right hand and the primary nurse, myself, and my instructor were stunned that in less than 5 seconds the first 'push' of contrast had already made it out of the heart and into circulation. I wish I remembered what the test was.

I think the test you are thinking of is to study and observe the fluid dynamics of the heart. If there are anomalies, there will be turbulence or abnormal blood flow. The contrast makes it visible and measurable.