What is NS NOT compatible with?

Specializes in MS, PostPart, Ortho, Nurs. Ed..

I was pondering what normal saline is not compatible with. Thanks.

53 Answers

Specializes in Education and oncology.

Hi "2blessed", great question! I know of just 2 medications that are NOT compatible with normal saline: amphotericin B (for fungal infections) and GM-CSF (Sargramostim) to stimulate granulocytes and macrophages in oncology patients and HIV patients.

Anyone else know of other incompatabilities?

Jess:typing

Specializes in onc, M/S, hospice, nursing informatics.

Valium

Amphotericin-B (Amphoterrible as it is often called)

Can't think of more right now... just woke up! :smilecoffeeIlovecof

Specializes in Acute Care Cardiac, Education, Prof Practice.

Yeah I was going to say Valium as well.

Sodium Bicarbonate-always mix that with D5W.

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

Propofol drips...at least at our hospital.

Biacarb drips are always mixed with D5W, never NS.

Dilantin actually requires a flush with NS before and after if giving in an IV that has D5W infusing. It is not stable with any dextrose.

Specializes in Acute Care Cardiac, Education, Prof Practice.
I have never heard that about valium before- I give valium IVP followed by a NS flush ALL THE TIME! Never had any problems.... Or is it just incompatible to mix it in a NS minibag???

Listed in my drug book it specifically states do not dilute or mix with other drugs. I think it may be a viscosity/solubility thing. I think it is fine to chase it down the IV with NS, but just not to pull it up and try to dilute it.

Maybe we can find a pharmacist.

Oddly enough as I searched the web for info I came across a drug "lovers" site. As they discussed the ways to manage diazepam, cooking, snorting, SL etc they said it is only "slightly" soluble in alcohol, and not at all in NS. This might lead to a particulate in the syringe if mixed.

They also said it burns like hades if you try to snort it lol.

Ahh people and their need for a high.

Taitter

Specializes in Hospice.

I was a hospital IV tech for 3 years and we did mix Sodium Bicarb drips in NS. Even after I double checked the info in the link that I provided above that states NAHCo3 is compatibile with NS, you still made me second guess myself, so I called the pharmacist at the hospital. He confirmed Sodium Bicarb is compatible with normal saline. Maybe it just depends on the facility's policy. Either that or a certain hospital in my neck of the woods is NOT helping a lot of people when they hang their Bicarb drips. :selfbonk:

Most patients that require Bicarb drips are usually those that have issues with acid-base balance and are many times renal patients, so you do not give them the extra sodium with the IV fluids. Only use D5W for their drips.

Also to prevent kidney issues with dyes for cardiac caths, many times the patient will receive an IV for at least 12 hours before with bicarb and this is always ordered by the cardiologists in D5W as well.

Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.
I was a hospital IV tech for 3 years and we did mix Sodium Bicarb drips in NS. Even after I double checked the info in the link that I provided above that states NAHCo3 is compatibile with NS, you still made me second guess myself, so I called the pharmacist at the hospital. He confirmed Sodium Bicarb is compatible with normal saline. Maybe it just depends on the facility's policy. Either that or a certain hospital in my neck of the woods is NOT helping a lot of people when they hang their Bicarb drips. :selfbonk:

You want the solution to be isotonic when giving Bicarb- that's why you may want to reconsider mixing it with NS.

Specializes in Med-Surg, Home Health.

Valium isn't compatible with NS, even for a flush. It can cause crystals to form. I hate to admit that I know this from first-hand experience.:chair: I gave Valium IVP and the flushed with NS afterwards. I noticed crystals forming in the extension tubing. I'd never seen that happen before, so I kinda freaked out a little bit (I, of course, didn't let the pt know I was freaking out). Anyway, everything ended up okay with that pt, but I will never do that again.

Specializes in Peds, ER/Trauma.
Valium isn't compatible with NS, even for a flush. It can cause crystals to form. I hate to admit that I know this from first-hand experience.:chair: I gave Valium IVP and the flushed with NS afterwards. I noticed crystals forming in the extension tubing. I'd never seen that happen before, so I kinda freaked out a little bit (I, of course, didn't let the pt know I was freaking out). Anyway, everything ended up okay with that pt, but I will never do that again.

So what do you flush it with? Do you actually draw up a flush of D5 1/2 NS? I've been a nurse for 4 years, and have always flushed with NS, and have never had a problem....

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