PIV seizure

[joe007]

So, I had a patient come in who was having SOB. It happened to be a young teen. As we were getting a PIV, the pt began to seize. The nurse who got the line and was able to draw blood back easily. The doc was at bedside anxiously asking if pt. had gotten ativan yet. I got some ativan and was ready to IV push. I decided that since the PIV was giving blood back easily that getting ativan into pt's system as quickly as possible by flushing line with ativan was a good idea (I usually flush with saline as per normal patient.) The nurse that put in the line asked me to flush it with saline before ativan, which I did per her request. It was a good line. I then gave the IV ativan.

Would any of you give a med in an emergent situation in a PIV that had good blood return without flushing first with saline to expedite giving medication. I also was thinking that even if PIV would have blown, which I didn't really think was a possibility given the ease and rate of blood return, that the ativan at least would be in the body and slowly absorbed vs waiting to try to get another line which could have taken a few more minutes because she didn't really have too many other acceptable sites for PIV. I know IM is the best way for ativan to be administered outside of IV access.

[meanmaryjean, DNP, RN]

You can get blood return on a blown vein. Flushing was a good idea- and the couple of seconds you spent doing that did not impact treatment at all.