Question about rocephin

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Specializes in LPN, Peds, Public Health.

So my question is... How many of you mix xylocaine with rocephin instead of sterile water?

My reasoning is... I have always been taught to do so. I worked in Peds for 4 years and all the peds nurses that I worked with and I always used xylocaine with our rocephins. Well now I work somewhere else and people keep using sterile water so when I asked why they said that they cant mix the xylocaine with rocephin on infants/toddlers... Has something changed that I am not aware of? One of the nurses even gave a gram of rocephin to an adult and used sterile water instead...

Any info would be greatly appreciated.

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Currently, I give it to victims of rape for STD prophy in the ED and the standing orders are to mix Rocephin with lidocaine.

On the peds floor, we give Rocephin IM to infants, and it comes premixed in a syringe from pharmacy. It is labeled clearly to give IM, not IV, as it contains lidocaine.

This is a little different than a previous state where I formerly lived. THe state practice act did not allow generalist nurses (aka those who were not advanced practice nurses) to administer lidocaine in any way except topically, so we didn't mix it with lidocaine to give it IM.

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Specializes in LPN, Peds, Public Health.

hmmm... i dont know what their reasons are. i told them they better not try to do that to my kid if he needs one haha...

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Specializes in ED, Flight.

I'm sure this is done safely, but I could see caution (or too much caution) given that Lido is a potent cardiac drug which can induce (as well as suppress) arrhythmias.

Of course, many of our meds have potential nasty effects. We have to use them safely.

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Specializes in Community, OB, Nursery.

Used to mix it w/ lidocaine all the time, just not on infants/toddlers.

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When I have an IV go bad and get the IV abx switched to rocephin, I always request it ordered mixed with lido. Why we can't have that as a standing order and I have to ask for it special in a pediatric hospital, I'll never understand.

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Specializes in LPN, Peds, Public Health.
Used to mix it w/ lidocaine all the time, just not on infants/toddlers.

why not on infants and toddlers? Is there a reason? Im curious because I dont want to be doing something wrong. But I have givens hundreds that way and never had a problem?

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ours comes w/lido.

but according to the many, many pts i've given it to, both (lido and water) hurt like the dickens.

but it is a darned good abt...until our pts build a resistance to that as well.

leslie

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Specializes in LPN, Peds, Public Health.
ours comes w/lido.

but according to the many, many pts i've given it to, both (lido and water) hurt like the dickens.

but it is a darned good abt...until our pts build a resistance to that as well.

leslie

i agree... my kids had to have them a lot due to ear infections, and i have had them too and i know they hurt like hell, but i think the lido helps after the initial burning goes away.

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I think its the policy of the hospital whether or not to mix with water or xylocain. I have done both. I guess it depends on the md order tooo.

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I work in family practice and urgent care clinics. I know that the family practice physicians have us mix rocephin with lidocaine for both adults and children. When I work in urgent care, there is one provider who wants rocephin mixed with sterile water for all minors. Her reasoning is it hasn't been proven how fast lidocaine is absorbed by the under 18 year olds.:heartbeat

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Specializes in Emergency, outpatient.
Here is a good thread about rocephin IM; there are a few other threads discussing it, too.
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