Pushing 0.5 ml med into a central line

[Neverbefore]

Hi everyone,

I'm a new nurse.

The other day I had to give a patient 0.5 mL of benadryl IV push. He had a chest port (central line).

The benadryl was in a 1ml vial.

Here is how I did it. Please tell me if there is a better way.

I got my smallest syringe, 3ml, and drew up the 0.5 mL.

I knew I had to give the med in a 10ml syringe (since it's a central line), so I took a 10 ml syringe of normal saline, squirted out about half of it, then injected the 0.5 mL into that, (my drug guide said you can dilute it).

The thing that bothered me about this is that 0.5 mL is such a tiny amount, and it seems like by the time I inject it into the 10 mL syringe, I've already lost some just from the transfer--like some of it was probably stuck to the sides of the original syringe and needle, etc. I feel like the patient isn 't getting the full dose.

What do you think? Should I be concerned about this? What do you do?

[wooh, BSN, RN]

That's how we give meds all the time (in peds, it's always tiny amounts.) Anything over 25 mg of benadryl should be diluted anyway (whether central line or not.) Unless you're spilling during the transfer, it's fine.

[fiveofpeep]

Why can't you draw it up with the 10cc syringe? Maybe I'm confused by the question.

[wooh, BSN, RN]

You'll get a more accuract 0.5ml in a smaller syringe.

[fiveofpeep]

So how do you transfer something from one syringe to the other? I never give benadryl IV and the only thing I have to dilute is ativan. Everything else I just give into the main line.

[wooh, BSN, RN]

Needle (or in our case, the blunt metal thing that we draw meds up with instead of with a needle) on small syringe. Draw up med. Big syringe, without needle, pull back so there's room for the med in it. Stick small syringe's "needle" into the hole of the big syringes leur lock spot, inject into the big syringe. (See it done once, makes perfect sense. Read my description, and I might have broken your brain.)

[fiveofpeep]

Thanks. That's what I thought, but wanted to be sure. I was never taught this and have never seen anyone do this but it's a great idea I will include in my practice. That is a lot more precise.

[FLArn]

Draw up the 0.5 ml of med in the 3 ml syringe. Squirt out only 2.5 to 3 ml of the NS in the 10 ml syringe. Aspirate 1 to 1.5ml of NS from the 10 ml syringe into the 3 ml syringe to dilute the med then inject the contents of the 3 ml syringe into the 10 ml syringe. By diluting the med while in the smaller syringe you lose only an insignificant amount of med in the dead space of the smaller syringe.

Hope that made sense.

[ckh23, BSN, RN]

I think people are making this out to be way to complicated. Take your 10ml flush and waste 1 ml then draw up the whole 1ml of Benadryl giving you a total of 50mg in 10ml. Then waste 5ml and you have your dose and you don't have to worry about doing all this transferring.

[fiveofpeep]

I think people are making this out to be way to complicated. Take your 10ml flush and waste 1 ml then draw up the whole 1ml of Benadryl giving you a total of 50mg in 10ml. Then waste 5ml and you have your dose and you don't have to worry about doing all this transferring.

this is how I was taught

[wooh, BSN, RN]

But then you have to make TWO accurate measurements and have TWO places to make an error. With my method, you only have to make ONE accurate measurement and only have ONE time to easily make an error. :)

[ckh23, BSN, RN]

To each his/her own.