What is the proper technique for administering IV push meds through a peripheral or central line?
Do you clamp the tubing while pushing in small increments? Some nurses say this is then called bolusing. I would like to know the correct technique for IV push.
Thank You.
Bolus is a rapid injection and should not routinely be done for any drug unless the drug literature specifically states a rapid injection.
As a general rule, I would prefer to give an IV push medication with fluids infusing. Some drugs require this (e.g. promethazine) and this is a huge issue in multiple lawsuits when promethazine is given through a saline locked catheter. Then if there is any drug added to the primary fluids, you must assess compatibility before injecting and infusing simulataneously. If there is an incompatibility or no specific compatibility information can be found, the nurse must stop the infusion, flush with saline, give the injection, flush with saline again and then resume the fluid flow rate. This is required if there is no other IV site or lumen to use. The rate of IV push depends upon each drug and is found in books such as Intravenous Medications, published annually be Mosby. There is no hard and fast rule for giving the push with or without fluids infusing and the rate of injection is specific to each drug. This is why all nurses must have some type of access to valid, reputable drug literature. For any and all IV medications, the gold standard is the book I listed. Others may have access to this information on a computer such as Micromedex. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861