Administering D50

[Shelbmedic]

I have never seen this done. I was taught if your IV was patent (large bore IV and AC) then push the D50 with the line wide open.

However I did witness an ER Doc push D50 through a 22g IV. It was really scary to watch. I left before the vein blew up.

[canuckEMT]

I will aspirate during D50 admin after half the amp, then push the rest. While continually monitoring the site for patency and infiltration. But 3 times seems a little much for me.

Oh and as well, pinching the line upstream from the med port then flushing with approx 20 mL after administration.

[Paramagic14]

question for all you......do you leave you line running wide open during D50 administration to dilute the D50 to make it easier to push?

[Ridryder 911]

Depends on the patient... if it is an older patient that appears not to need anymore fluid (Hx CHF, CRF etc...) no, I don't. What I ave found, so many attempt to "push so fast".. I do push some allow a little fluid, allow to dilute so it will not "burn" the vein.

R/r 911

[AZCEP]

I will allow the fluid to run wide open, patient condition dependent of course, and push the dextrose just fast enough to allow the fluid to continue running while I'm administering the medication.

It can take quite some time to get the full 50 mL delivered in the case of small catheters, cold medication, etc. but the upside of less sclerosing of the vein is worth it.

[1EMT-P]

I have never heard of aspirating three times while administering D50. I was always taught that you check the line before administering the D50 and again after administering the D50.

[paramedicmike]

However I did witness an ER Doc push D50 through a 22g IV. It was really scary to watch. I left before the vein blew up.

I've done this before...push D50 through a 22g IV cath before. Was it ideal? Not really. Did the patient need it? You bet. Did the patient have any other access besides this tiny vein in her hand? Not on your life.

It was a very slow push. I kept an eye on the IV site for the duration of the push. The vein did not blow.

If you're careful and watch what you're doing it's not a big deal. If you can continue, then continue. If you have to stop, since you're watching closely, you stop.

-be safe

[Ridryder 911]

Show me very many chronic diabetics with good peripheral veins...... I would love to have any line... Heck, I have used 24g... yes, it is slow but as long as it works and flows.....

R/r 911

[Paramagic14]

....Gotta love that EJ!

[BushyFromOz]

on one of my on-road practicums...i saw an ER doc squirt the D50 into a cup and get the patient to drink it