Question about diluting med

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Say you need to give 1 mL medication X IVP over 2 minutes. The drug book says to dilute with an equal amt of normal saline. When drawing this up, do you pull med then saline or vice versa???

Thanks!!

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Specializes in Rehab, Med Surg, Home Care.

Since I am drawing saline from the "community" bag hung in the med room I would draw the saline into a syringe first, then the med, then about a cc of air so I can gently mix the liquid to dilute. Then i would hold the syringe upright to expel the air and I'm good to go.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

It's safer to pull the medication into the syringe first. If you are drawing from a multi-dose vial or drawing from a larger amount, you can always put back any overage of the medication you draw. However, if you draw up the saline first and then pull too much of the medication into the syringe with the saline, you have to discard everything and start all over. It's not such a big deal if you pull a little too much saline into the correct amount of the medication.

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What I'm afraid of is tainting the "community" saline. Is this an issue if I draw the med, then the saline? Will there be any remnants of the med in the saline vial? Also, what would be the best way if there's a pre-filled syringe of saline? Got a check-off next week and this just came to me as an issue. So, I'd like the most appropriate "nursing school" answer. If you know what I mean.

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Specializes in Rehab, Med Surg, Home Care.

Yeah, well, the correct "nursing school" answer is however the instructor says to do it. If you ask well ahead of the check-off, they should be willing to provide the technique they'll expect to see.

(hope the test goes well.).

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Specializes in med/surg, telemetry, IV therapy, mgmt.
What I'm afraid of is tainting the "community" saline. Is this an issue if I draw the med, then the saline? Will there be any remnants of the med in the saline vial? Also, what would be the best way if there's a pre-filled syringe of saline? Got a check-off next week and this just came to me as an issue. So, I'd like the most appropriate "nursing school" answer. If you know what I mean.

I would use a fresh vial of saline and then discard the unused portion. Saline is cheap. The drug is going to be charged to the patient, so if you mess up and have to get another vial of the medication, it's going to get charged to the patient.

You can take the needle off the syringe after you have drawn the medication into it and shoot the NS from a pre-filled syringe into the hub now minus the needle. Reapply the needle after putting the NS into the barrel of the syringe with the medication. Carpuject prefilled saline syringes are actually mini-vials with removable needles. You can pop off the needles and access the saline solution inside their barrel/vial through a rubber diaphragm you will only see once you remove the needle.

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Specializes in Med/Surge, ER.

I always draw up my medication first, then the saline. For example, when I give Morphine, I dilute it 10mg to 10cc of saline, so it's a 1:1 concentration, and I then waste what I don't need.

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Specializes in PICU, surgical post-op.

I usually grab a syringe and needle and draw up however much saline I want to dilute with. Then I draw up my med in a TB syringe, pull the needle off the saline syringe and squirt the med in. Or, I'll just waste a little saline out of a pre-filled flush and then do the same process with the TB syringe. Not sure if it works in the adult world or only with peds where dosages tend to be smaller...

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