Guest guest Posted February 9, 2001 Report Share Posted February 9, 2001 Gene: That follows my understanding, too, although we used to teach that you should push Hyperstat rapidly back in the crazy days when some EMS services carried that amp of bad news. Even that began to change before the drug more or less faded into EMS history. I think Jim's statement about pushing it rapidly was meant to indicate that it was a bad idea. Dave [texasems-L] Fast IV pushes > Recent correspondence has mentioned pushing promethazine rapidly per IV. I > am of the opinion that there are only two IV drugs that should be pushed > rapidly other than in codes: adenosine and atropine. Am I correct? > Partially correct? Wrong? Please let me know. > > E. Gandy, JD, LP > EMS Professions Program > Tyler Junior College > Tyler, TX > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2001 Report Share Posted February 9, 2001 Thanks Dave, that certainly was my intent. If I give phenergan I dilute it in about 9 cc of NS prior to pushing and give over a couple of minutes. It still burns but most units and E.R.s' don't carry neut. Stay safe Easley Re: [texasems-L] Fast IV pushes Gene: That follows my understanding, too, although we used to teach that you should push Hyperstat rapidly back in the crazy days when some EMS services carried that amp of bad news. Even that began to change before the drug more or less faded into EMS history. I think Jim's statement about pushing it rapidly was meant to indicate that it was a bad idea. Dave [texasems-L] Fast IV pushes > Recent correspondence has mentioned pushing promethazine rapidly per IV. I > am of the opinion that there are only two IV drugs that should be pushed > rapidly other than in codes: adenosine and atropine. Am I correct? > Partially correct? Wrong? Please let me know. > > E. Gandy, JD, LP > EMS Professions Program > Tyler Junior College > Tyler, TX > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2001 Report Share Posted February 9, 2001 Dilute it in 9cc? Why 9 (curious)? Are you diluting the entire 50 in 9 (making 10cc of solution) and giving 2.5ml total solution? Let's see.. our ampules of Phenergan are 50mg/ml. Our IV dose is 12.5mg. So, 50mg/ml / 12.5mg = 1/4ml, or .25ml. So, typically I end up drawing it up into a 1cc syringe, pushing my .25ml, then flushing with 3-5cc of saline (or running the line wide open for a few seconds). This way, I don't have to worry about dilution concentration, etc... Mike > >Reply-To: >To: < > >Subject: RE: [texasems-L] Fast IV pushes >Date: Fri, 9 Feb 2001 09:19:05 -0600 > >Thanks Dave, that certainly was my intent. If I give phenergan I dilute it >in about 9 cc of NS prior to pushing and give over a couple of minutes. It >still burns but most units and E.R.s' don't carry neut. > >Stay safe > Easley > > Re: [texasems-L] Fast IV pushes > >Gene: > >That follows my understanding, too, although we used to teach that you >should push Hyperstat rapidly back in the crazy days when some EMS services >carried that amp of bad news. Even that began to change before the drug >more >or less faded into EMS history. I think Jim's statement about pushing it >rapidly was meant to indicate that it was a bad idea. > >Dave > [texasems-L] Fast IV pushes > > > > Recent correspondence has mentioned pushing promethazine rapidly per IV. >I > > am of the opinion that there are only two IV drugs that should be pushed > > rapidly other than in codes: adenosine and atropine. Am I correct? > > Partially correct? Wrong? Please let me know. > > > > E. Gandy, JD, LP > > EMS Professions Program > > Tyler Junior College > > Tyler, TX > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2001 Report Share Posted February 9, 2001 It makes for tight control of administration and dosage. 50mg/1cc + 9cc NS = total con. 5mg/cc. If desired dose is 12.5mg, give 2.5 cc of a nicely diluted mixture and your patient will thank you for it. The undiluted 0.25cc of phenergan can still cause local phlebitis. Also, in the back of a swaying moving truck, (unless your driver has been to a chauffeur school), I question the accuracy of giving only 0.25 cc of anything. More chance for dosage error when dealing with small amounts of volume. I would also have phenergan 25 mg instead of the 50 mg vial, less waste and expense. No offense intended. Stay safe Easley Re: [texasems-L] Fast IV pushes > >Gene: > >That follows my understanding, too, although we used to teach that you >should push Hyperstat rapidly back in the crazy days when some EMS services >carried that amp of bad news. Even that began to change before the drug >more >or less faded into EMS history. I think Jim's statement about pushing it >rapidly was meant to indicate that it was a bad idea. > >Dave > [texasems-L] Fast IV pushes > > > > Recent correspondence has mentioned pushing promethazine rapidly per IV. >I > > am of the opinion that there are only two IV drugs that should be pushed > > rapidly other than in codes: adenosine and atropine. Am I correct? > > Partially correct? Wrong? Please let me know. > > > > E. Gandy, JD, LP > > EMS Professions Program > > Tyler Junior College > > Tyler, TX > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2001 Report Share Posted February 9, 2001 Agreed that pushing promethazine fast was mentioned as an example of a bad idea. Just wanted confirmation that I wasn't entirely off base in thinking that adenosine and atropine are about the only ones we'd push rapidly other than in a code. GG E. Gandy, JD, LP EMS Professions Program Tyler Junior College Tyler, TX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2001 Report Share Posted February 9, 2001 Agreed. I hate the 50mg vials. Mike > >Reply-To: >To: < > >Subject: RE: [texasems-L] Fast IV pushes >Date: Fri, 9 Feb 2001 13:13:21 -0600 > >It makes for tight control of administration and dosage. 50mg/1cc + 9cc NS >= total con. 5mg/cc. If desired dose is 12.5mg, give 2.5 cc of a nicely >diluted mixture and your patient will thank you for it. The undiluted >0.25cc of phenergan can still cause local phlebitis. Also, in the back of >a >swaying moving truck, (unless your driver has been to a chauffeur school), >I >question the accuracy of giving only 0.25 cc of anything. More chance for >dosage error when dealing with small amounts of volume. I would also have >phenergan 25 mg instead of the 50 mg vial, less waste and expense. No >offense intended. > > >Stay safe > Easley > Re: [texasems-L] Fast IV pushes > > > >Gene: > > > >That follows my understanding, too, although we used to teach that you > >should push Hyperstat rapidly back in the crazy days when some EMS >services > >carried that amp of bad news. Even that began to change before the drug > >more > >or less faded into EMS history. I think Jim's statement about pushing it > >rapidly was meant to indicate that it was a bad idea. > > > >Dave > > [texasems-L] Fast IV pushes > > > > > > > Recent correspondence has mentioned pushing promethazine rapidly per >IV. > >I > > > am of the opinion that there are only two IV drugs that should be >pushed > > > rapidly other than in codes: adenosine and atropine. Am I correct? > > > Partially correct? Wrong? Please let me know. > > > > > > E. Gandy, JD, LP > > > EMS Professions Program > > > Tyler Junior College > > > Tyler, TX > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2001 Report Share Posted February 9, 2001 Thank you, , for mentioning the dilution in NS. I recommend that be done with several drugs where the concentration is high as, for example, the old 10mg/ml morphine amps. The dilution makes titrated administration so much easier. Apparently this is never mentioned to some classes and comes as a surprise to some medics. Gene E. Gandy, JD, LP EMS Professions Program Tyler Junior College Tyler, TX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2001 Report Share Posted February 12, 2001 As we say to the guys in the tower, " Ah...roj. " I think you got it 110% correct. Dave Re: [texasems-L] Fast IV pushes > Agreed that pushing promethazine fast was mentioned as an example of a bad > idea. Just wanted confirmation that I wasn't entirely off base in thinking > that adenosine and atropine are about the only ones we'd push rapidly other > than in a code. > > GG > > E. Gandy, JD, LP > EMS Professions Program > Tyler Junior College > Tyler, TX > > > Quote Link to comment Share on other sites More sharing options...
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