janat

Thanks for the responses. One suggestion another nurse made was to use more lido to dilute. The Mfg says you can dliute 1 Gram with 3.6ml lido. This makes a total of about 4ml which seems like a lot to give all in one hip, but maybe it's better because of more lido. I haven't been dividing the dose between hips, because I have been giving the Decadron on one side, and the Rocephin on the other.

I work in a new primary care practice that treats alot of adolescents and young adults. For more serious or recurrent ear infections and upper respiratory infections, our doctor often prescribes 1 Gram IM Rocephin along with IM Decadron. The Rocephin is pretty tough for most patients to take, especially teenagers. I use 1% lido, which makes about 3.3ml which I give in one hip, and the Decadron in the other hip. Any suggestions or ideas on how to make this more tolerable for the patient?

Thanks for the response. Some people have said that since the mfg makes a 4ml pre-filled syringe, then it must be okay to give that much in one site. I will see if the Dr. will agree to divide into two sites. Even a 2ml Bicillin shot is painful. 4ml is really uncomfortable for most patients.

I work for a Dr. who treats a lot of Lyme patients. For some patients, the Dr. has prescribed IM Bicillin LA, in weekly doses. Usually the dose is 1.2M units, but for others, the Dr. has increased the dose to 2.4M units per week. The Dr. prefers that the the 2.4M dose is given in a single injection, all in one buttock. His reasoning is that while it is a large injection, it is easier on the patient overall rather than splitting into two sites, since the injections can be alternated between buttocks every other week. The manufacter supplies the 2.4M Bicillin dose in a 4cc volume, and a disposable syringe with an 18g 2 inch needle. Adminstering this volume with this needle has been a pretty uncomfortable experience for most of my patients. Does anyone have experience with the 2.4M dose vs. splitting the dose into two sites? Thanks.