Dilaudid IV Push - page 2

by hdreserve 15,500 Views | 19 Comments

Administration as started allowing physicians to order dilaudid IV push (& other opiates) in the Intake area of our Emergency Room. These patients are receiving this in a rapid treatment area with no monitoring/proper... Read More


  1. 0
    Who would be liable?
    The person administering the medication! Doctors and admins can bark orders all they want, but good nursing judgement dictates that you know it is not safe to administer one of the strongest respiratory depressing opiates out there to patients who are not monitored by pulse ox at the very least and one RN with full monitor at best.

    You know in your gut this is not ok!
  2. 0
    That's ridiculous. Not only have they not had their MSE, they're not monitored, med recs haven't been done, and I bet you a billion kazillion they elope with their saline locks intact! No thanks, no matter how much admin thinks it'll improve patient satisfaction! (and we all know that's the real reason!)
  3. 1
    NO WAY would I ever do this. There are several problems here. It seems like an adequate assessment has not been completed,including an allergy history and complete pain assessment. The Joint commission (TJC) their new name, states there must also be an assessment after the administration to detemine effectiveness..are those policies in place...is there a nurse assigned to each of these patients????? How will the patient be monitored for drug hypersensitivity and/or side effects such as respiratory depression??? Is it even feasible to start an IV in a crowed intake area and keep the area clean and free from bodily fluids and exposure of these to other pts....YUCK. It seems to be another way to keep the customer "HAPPY" instead of fixing the problems of our overcrowded and improperly used EDs
    MassED likes this.
  4. 0
    Thanks everyone for your responses. We have our first meeting tomorrow morning & It really helps having the input of so many great nurses with invaluable work expertise.
  5. 0
    http://www.fairview.org/static/scope_0803.pdf

    http://www.thedoctors.com/KnowledgeC.../CON_ID_002959

    There should be some worthwhile information in these two links. Respiratory depression is a big thing. I would question giving it to anyone who uses home CPAP. I know of a case of a woman who went to the ER C/O neck pain. They examined her, gave her PO dilaudid and sent her home. She neglected to put on her CPAP and her husband found her dead in the morning.
  6. 0
    Yikes! Which proves the point that Nursing is not to be taken lightly AND admin does not always have our backs! Our practice is completely on us!
  7. 0
    I would probably operate under the personal code of "if I give it, I follow up on it." I don't feel comfortable giving Dilaudid and taking off - especially Dilaudid, I keep an eye on my patient's respiratory status and oxygen sats. I had a patient go south pretty quick after some Dilaudid IV - open tib/fib. Sats went into the 40's FAST even w/ slow administration. I don't think using IV Dilaudid is a good idea in a quick triage area - maybe IM or PO?
  8. 0
    Quote from medic2033
    Also, once the seekers learn about this, they can get their shot, then just get up and leave.
    That's the best reason of all not to give it. No way!!!!! Give a med and have a person take off and drive away. Yikes.
  9. 1
    Quote from iluvivt
    NO WAY would I ever do this. There are several problems here. It seems like an adequate assessment has not been completed,including an allergy history and complete pain assessment. The Joint commission (TJC) their new name, states there must also be an assessment after the administration to detemine effectiveness..are those policies in place...is there a nurse assigned to each of these patients????? How will the patient be monitored for drug hypersensitivity and/or side effects such as respiratory depression??? Is it even feasible to start an IV in a crowed intake area and keep the area clean and free from bodily fluids and exposure of these to other pts....YUCK. It seems to be another way to keep the customer "HAPPY" instead of fixing the problems of our overcrowded and improperly used EDs
    starting IV's prior to a complete evaluation? Unless a person comes in unable to ambulate or intractable back pain, who has the time to do that all in the name of expeditious care at the front end? Please! Providers and hospitals are so eager to please the drug seeking population, why not offer Motrin/Tylenol PO for all at the door?
    Altra likes this.
  10. 0
    Quote from MassED
    That's the best reason of all not to give it. No way!!!!! Give a med and have a person take off and drive away. Yikes.
    I STILL don't know why we are giving out so much Dilaudid! This is a powerful opiate that should really be reserved for end stage pain. Why is every chronic pain pt. on it, and why is it so routinely ordered?


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