Administering D50

[akflightmedic]

Ok guys, its time to educate me. If I am wrong please let me know and why.

On another website, there is a discussion about D50 and aspirating back while administering it.

I will admit, I have never aspirated back while giving D50. I was never taught this and I have never witnessed anyone do it. Doesnt mean we are right, I am just stating my experience.

I am under the impression that if I establish a patent IV and watch closely while administering, there is no need to aspirate back. However I have been informed that it is normal to aspirate 3 times! Before, during and after. This seems a bit overkill to me and I would like to hear some other opinions with regard to this practice.

As I said I have never been taught it, nor have I taught it to my students. If this is a critical error I need to correct please tell me so and justify it.

[Guest CHP medic]

Hey AK. Yes, I was taught to aspirate blood prior to administering D50 and did it everytime, for a while. I dont anymore. Like you said, if you're sure you have a patent line and adm. the D50 slowly, just monitor it closely. Maybe I'm wrong too, wouldn't be the 1st time.

[vs-eh?]

Sorry, aspirate the line for blood to ensure patency? Naw...You would do this PRIOR if patency was an issue, but I RARELY do this. There are many ways to ensure patency other than aspiration of blood, and certainly not specific for dextrose admin.

Hypertonic solution I know, necrosis...I assume this same "rule" is applied to dopamine, etc...

D50W is administered via bolus (50ml) though...I'm sure infiltration, extravasation, problems with infussion, etc....would be grossly present soon after administration.

Before, during, and after? LOL...

So what, you get aspiration but ignore that big bump appearing at the site until you suddenly can't aspirate after you gave the drug? Silly...

You are constantly evaluating the site, aspiration is simply one way...

[Wraith]

Normally what I do is hold the IV bag lower that the IV site and see if blood runs back into the IV line. Then I raise the bag back higher than the site and the blood runs back in and the line clears. Then if I am satisfied with the results of this small test I perform my administration while watching the site for signs of extravasation. I've used this technique for 14 years now and have never had a problem with it.

[cwilliams17]

During my EMT-Enhanced class and paramedic school, we were taught to aspirate up to three times to confirm that we have a patent IV line to prevent necrosis of the tissue. But I agree with AK about monitering the site during administration and knowing you have a patent line prior to giving it to the patient.

[Ridryder 911]

I have never heard of such, nor never seen in any policies and orders.. which I have seen many. I have seen to be sure to have a well patent line.. (which if one wants to check patency, I guess one could aspirate?), then flush afterwards .. to be sure the fluid is pushed through.

I don't really think it matters as long as one makes sure it is patent line.

R/r 911

[paramedicmike]

I wasn't taught this. But I have seen it done. I've always wondered why. Unfortunately, when I asked, the answer I got was, "I don't know. It's what I was taught."

As with any IV start and medication administration, we monitor the IV site for patency. We don't aspirate with any other med. I couldn't understand why people did it with D50. So long as you're paying attention to what you're doing you're good.

-be safe.

[nsmedic393]

I never heard of this practice and have never seen anybody do it. If you are competant at starting Ivs than just monitoring closely while pushing D50 should be enough.

Sounds like yet annother rule for the lowest common denominator.

[northernmedic]

We mostly use D10W which I much prefer.

[Paramagic14]

In my paramedic class ...which i just finished 4 months ago we were taught (or reminded rather) to Aspirate prior to administration and after every 10-15ml to ensure IV patency since the medication will cause necrosis and to cannulate the largest vein possible and run the IV wide open prior to and after administration to check for patency. They also told us to hand the bag low and look for blood return to make sure its patent. This is actually in our pharmacology manual for D50.