Preparing IV antibiotics : Articles/Internet sites/ videos

thumperxx · Jun 24, 2012

Hi everyone,

I am new here.I am a new Nurse also and have just started my first job on a medical/ surgical ward.I am enjoying it alot. I am having difficulty though with preparing IV antibiotics. Ok so i want to give 1.2g of co- amoxiclav to a pt (bolus). I need to reconstitute it with 20mls of Water and give it over 3-5 minutes. I get that. But i am new to IVs and as a student we didnt get trained in this area at all. I cant seem to add the water to the vial without GREAT difficulty. I dont get it?? it just sprays all over my hand (and i am allergic to penicillin , i must wear gloves!!). Please tell me what im doing wrong? there is great pressure trying to get the 20mls of water into the vial. please give me some tips on how to reconstitute this powdered medication and then draw it up? HELP!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! thank ye in advance :)

KelRN215, BSN, RN · Jun 24, 2012

Can you describe how you are doing this and maybe we can help figure out what you are doing wrong?

AgentBeast, BSN, RN · Jun 24, 2012

It stands to reason that you need to draw out 20 mL of air from the vial before you put the 20ml of sterile water in.

thumperxx · Jun 25, 2012

Thanks guys,I hope ye can help me.What I am i am doing is I draw up 20mls of water for injection into a syringe. Then I open the vial by flipping off the blue cap. Now I see a brown rubber thing on the top of the vial which i insert my needle into this. My needle is attached to the syringe with the water for injection. I am now literly syringing the water for injection into the vial, but there is so much pressure that when i do it after a couple of mls i find it really hard to insert the water. i am afraid because the vial is glass? if i stop syringing with my needle still in the vial , it will automatically come back up into my syringe (with the pressure??). So is it that i should first inject 20mls of air into the vial first? would that not make it blow up or smash?

I know i must sound so stupid, but if i could just get this, understand this id be so happy

thumperxx · Jun 25, 2012

i meant is it that you withdraw 20mls of air like scotte said?ive never seen this done before? how do you do that?

Silverdragon102, BSN · Jun 25, 2012

try again, posted something but it got lost

Draw required mixing solution into syringe, slowly add solution to vial releasing syringe plunger intermittently to allow air to leave vial and enter syringe. Once air and solution have swapped hold vial and syringe in one hand and mix. Reverse the process by turning vial up side down and pushing air into via and solution back into syringe. You should not have any spraying if done slowly

thumperxx · Jun 25, 2012

Thanks for your reply Silverdragon102! So basically when i begin , i shouldnt have to inject air into the vial is that correct? So then i just slowely as you said admit my 20mls of water for injection into the vial using the plunger intermittently? So it wont blow up if i do this? Always when i let go of the plunger (when i take a break to stop syringing the water into the vial) it still fells like alot of pressure to keep the syringe as far as ive got it without the plunger autimatically pulling back on me.

Is that normal? Should it feel a little hard like your pushing the water into it?Is that normal

And do you say when i have it mixed (reconstituted), and i turn the vial upside down, am i meant to just draw back as i would any injection.

Sounds so confusing when typing this. I wish i could watch a video of someone doing this with every single step mixing 1.2 co- amoxiclav.Sorry for sounding so dumb, but if i just got it into my head id be ok. I always find it so hard, Its ok mixing something like crystapen, as i only inject 2mls or whatever into those tiny vials, but co- amoxiclav is much bigger and needs much more water!!!

Silverdragon102, BSN · Jun 25, 2012

Where are you? Can you not ask any of your colleagues to help you?

thumperxx · Jun 25, 2012

Im on a few weeks off at the moment. I work in a medical and surgical ward. I should be enjoying my time off but im trying to find out about drawing up antibiotics without all the crap. I have had help off of collegues but its always so busy and i get it all , except for the pressure part. And i cant seem to find the answer anywhere. No matter how much i practice, and you cant really practice in work , you cant waste medication to practice. It just always seems to go wrong, i get it mixed evetually , but alot of times the water is spewing out and ive lost about 3 mls. Im better to learn things, get it in my head and then practice it, At the moment im practicing with not knowing what im doing to stop all the pressure/spewing. Im off at the moment and want to feel more confident when i go back. But i do understand everyhting about iv abxs except reconstitution with an antibiotic that needs 20 mls mixed. I know it sounds dumb, but this is my main problem at the moment..

Im fine mixing for example 2mls with a 600mg of crystapen for example. Its just getting 20mls of water into a vial containing 1.2g of co-amoxiclav .

Silverdragon102, BSN · Jun 25, 2012

Forget about the 20 mls but think about adding a solution into a air pressured container. I used the same procedure regardless on amount of solution. Slowly add the mixing solution into the container but allow the air to transfer from container to syringe until full exchange has happened.If you have to draw back a little with the plunger the do it. Mix the solution and then do the reverse letting the air back into the container and the solution back into the syringe

Esme12, ASN, BSN, RN · Jun 25, 2012

Look here.......