Question re hypertonic solutions

[heron, ASN, RN]

Hi, all ... I work on a hospice inpatient unit. Today, a doc ordered an iv of 10% Dextrose to be infused into an antecubital line. I have two questions about this: 1) I was taught that hypertonic solutions should go into central lines because of risk of sclerosing a smaller vein. Is this still true? Is the antecubital vein large enough to take D10 safely? 2) Is it likely to hurt when given in that site? Thanks ... Heron

[vamedic4, EMT-P]

D50 is commonly given to patients in the field through peripheral lines, so I'm certain D 10 can be. You are correct that it is hypertonic so care must be exercised when administering this med. Do everything you can to ensure the IV is patent prior to beginning administration of D10, and, of course, be aware that it does interact with other meds like sodium bicarb and valium.

Just get it in the best vein you can - and check the IV site frequently for evidence of extravasation...we don't want infiltration of D10 (or any med for that matter!)

Have a good day!!

vamedic4

Hi, all ... I work on a hospice inpatient unit. Today, a doc ordered an iv of 10% Dextrose to be infused into an antecubital line. I have two questions about this: 1) I was taught that hypertonic solutions should go into central lines because of risk of sclerosing a smaller vein. Is this still true? Is the antecubital vein large enough to take D10 safely? 2) Is it likely to hurt when given in that site? Thanks ... Heron

[Binkey, BSN]

Heron,

According to Infusion Nurses Society(INS) standards,

Any solution with a dextrose concentration of greater than 10% should go centrally. These hypertonic solutions are too damaging to the intima of peripheral veins, and thus your phlebitis and thrombus rates go way up... Not to mention what could happen if these solutions extravasate!

Diane

[tridil2000, MSN, RN]

D10 is the peripheral max.

ppn has d10.