Wondering if anyone knows if an lpn in alberta canada can administer iv push meds.

UofCRN · Aug 13, 2010

Having just read through the posts that followed mine, I'm beginning to think that if you're an LPN here in Alberta the safest thing you can do is ask the CNE or unit manager if you're allowed to do IV push meds on your unit and if so, which meds & under what circumstances. I really think it depends on where you work. When I worked in California, I was allowed to do IV push meds all the time, including narcotics, beta blockers and midazolam, but when I returned to Canada, I found out that I couldn't do what I'd been doing in the States. Bottom line is, FIND OUT what you're allowed to do & what you're not allowed to do, for your patient's safety & certainly for your own. You also have your unit's policy & procedure manual to refer to, but I would ask my CNE first & then go through the p&p manual with him/her. Again, just to be safe ... :)

Pediatric Critical Care Columnist · Aug 13, 2010

I think with the ongoing shift to a provincial health service and the amalgamation of P&P across the province, we will see IV push become a province-wide special competence with certification as it currently is within the former Capital Health Region. Only "specially-trained RNs and LPNs" may administer meds IV push. When I go to rapid-response type situations I prefer to give meds myself because I know which ones I can push and I am covered to do it. (One ward nurse was going to hang a 50 mL minibag with a 0.5 mg/kg dose of dexamethasone to run over 30 minutes for a patient with stridor.) We're also called on to tPA central lines because it amounts to giving a high-risk med IV push. Sort of.

Fiona59 · Aug 13, 2010

Really? Wow. What about IV antibiotics or Zofran? We often get patients back with orders of ancef xxmg IV q8h x 3 doses or IV zofran as the first choice as an antiemtic. I see RNs do IV push meds all the time including the above mentioned and narctotics. That would be weird to have doctors do those which seem so routine to me. (Well routine to observe, not do personally)

Ancef (and all the other assorted IV antibiotics) and Zofran (Maxeran, Gravol, etc) are hung via secondary lines and aren't IV push as such.

LPNs and RNs do it as part of their everyday duties.

IV push ie: administering morphine via the IV line just isn't done on the general floors.

UofCRN · Aug 13, 2010

Some antibiotics can be given via IV push, such as Ancef ... I once had to give 2g IV push to a fellow who'd had a finger bitten off in a bar brawl! Some abx can also be given via syringe driver/Bard pump. But when in doubt, if the doc's orders don't seem right, just say that you're not comfortable with the order and ask the CNE or charge about it. Fiona59 is right about everything else, though ... most antibiotics and antiemetics are given IV when mixed in a minibag containing NS, although there are some of the more unusual meds, such as Octreotide, which can be given through an EZ set. As for the IV meds, some (most, I hope), have charts that specify how the meds (particularly abx) should be mixed and the time over which they should be administered (if you're using a gravity set and not a pump). :)

RGN1 · Aug 14, 2010

Bottom line is, if you haven not been trained/certified to do something, or you're not sure about it, don't do it!