So, we you are administering pain medication to a patient whom you are also administering fluid, especially through a large gauge catheter that flows really well. It doesn't really matter much how slowly your push your 1 ml of medication into the extension set. Because it probably won't get to the patient until you start running the fluid again.
That being said, don't open the roller clamp full bore right afterwards. It might end up in someone in the ambulance vomiting from getting pain meds too fast.
Not that this happened to me, I'm just saying.
This is a wonderful point rarely covered in EMS!
ReplyDeleteI know our extension sets are 0.6 mL, which means you could put 6 mg of morphine into the set without ever reaching the patient's circulation. Flush beware!
A handy way to give narcotics in most patients, as their side effects are administration-rate sensitive, is to draw the dosage up into a 10cc saline flush and administer it in 1 mL aliquots while a line is running just shy of wide open.
Push a little, talk a little, push a little, talk a little. Eventually they feel pretty good without feeling hazy, pukey, or otherwise unwell.
Again, it is great that you bring this up!
Thanks so much for this information. I have to let you know I concur on several of the points you make here and others may require some further review, but I can see your viewpoint. Research Chemicals
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