David Reinertso

Some meds are incompatible with some iv fluids. Dilantin and dextrose, for instance. Unless your memory is amazing or your local formulary is small, you'll have to ask where's the compatibility chart. The phrase "iv push" can mean to push over seconds, or minutes, or a half hour. It depends on the drug, the desired effect, etc. Our med reference often suggests something can be given iv push over 3-5 minutes or piggyback over 15-30 minutes. From that, I suppose this is because you need different equipment (piggyback tubing, pump, etc) to give something over 30 minutes, versus a minimal syringe and a needle for iv push. That's just my assumption. Your second question is about pinching above the port when injecting into a running iv. I, like some above, assumed that a typical modern running i.v. line has a pump above the port you're using to give the i.v. push med. So it wouldn't allow the medication to go backwards upstream toward the pump. I experimented in a kitchen environment, away from patients, using red food coloring as the "medicine", diluted in 0.9% NaCl. I found that, without pinching above the port, some "medicine" could literally float upstream. When I repeated with the medicine diluted in 5% dextrose instead of NS, little or no red "medicine" floated the wrong way. I think the reason is that NS is physically lighter than most i.v. solutions. It may simply float upstream if you don't pinch really close above the port until you have flushed it into the patient.