An ER "First" for Me...

Christy1019, ASN, RN · Jun 1, 2011

Yes, and they always call them "allergies". I've stopped trying to explain the difference between an allergy and an intolerance, as well as pointing out that some of their listed "allergic" reactions are actually common side effects. It just seems to go in one ear and out the other most of the time.

One time I had this pt who was a nurse, her chart said allergy to Epinephrine... so I asked what reaction she had and she says "it makes my heart race!" :confused: Ummm... okay. Didn't even go into it with her lol

SpEdtacular, MSN, RN, EMT-P · Jun 1, 2011

One time I had this pt who was a nurse, her chart said allergy to Epinephrine... so I asked what reaction she had and she says "it makes my heart race!" Ummm... okay. Didn't even go into it with her lol

I've heard that a million times. I've also seen a lot of allergies to blood pressure meds and/or nitro because "it drops my pressure" and aspirin because "upsets my stomach" (then you see they take ecotrin). I'm blanking out on the others I've heard. Recently I've had a patient tell me they couldn't take any medicine with mercury in it because they're allergic to mercury. Don't know where that came from. Maybe vaccines (I think some used to contain some form of mercury)? :confused:

bonestAx · Jun 2, 2011

Oh oh oh I had a patient decline a Lortab Rx !!! Thanks but I can get by with ibuprofen and Tylenol! :bugeyes: I was like.. are you sure? I wanted to hug that pt. And I am not that kind of nurse. At all.

Naaster · Jun 2, 2011

Post of from a c-cect I got Toradol with a duramorph epidural. I was pain FREE for 24 hours without sedation. I can't tell you how sad I was when they switched me to vicodin 1-2 Q8PRN. I suddenly had NO pain control. But I could sleep!

I requested 800 Motrin's and found Ultram when I got home. I remember the look on the nurse's face when I requested Motrin! Less sedation, and more pain control than any narcotic has ever given me. I won't say I've never had a pain get better with Vicodin, but it's usually only headaches. And I don't get those very often, and less often want to take Vicodin for it. Anything else, broken bones, muscle aches, sciatic, etc, just give me an Ansaid!

I get so angry at docs who toss Dilaudid at chronic pain patients, but want to give 2 morphine to the traumatic amputee. Even if both are begging for pain control. Heartless and irresponsible.

And as for the Toradol dosage, we now only give 30mg doses. Our pharmacy states new evidence for equal pain relief with 30mg's no matter the route. So it's rare that a doc will still give 60mg's at our hospital. We were also one of the first hospitals I know in the area to stop using Phenergan IV on peripheral veins. We lost several of our regulars when we did that.

allnurses Guide · Jun 4, 2011

Our latest policy on phenergan IV is now max of 12.5 mgs, in minimum of 10 mLs over 15 minutes. I just put it in a 50ml bag and put it on a pump.

I've had a few refuse narcs, but they are few and far between. We seem to hand out Lortab like candy.

On the other hand, we do have care plans in place to deal with some of the frequent flyers, and they don't get narcs most of the time. Our trauma pts are covered pretty well, just need to remind the docs sometimes.

Roy Fokker, BSN, RN · Jun 14, 2011

It is also very refreshing when you have patients who say: "Uhh, does the doctor think it's necessary? Is there something non-narcotic that might help? I have been clean for a while and don't want to risk it if I can avoid it."

cheers,

usalsfyre · Jun 14, 2011

I once was prescribed Vicodin 10/650 for pain after a fairly major auto accident (luckily didn't require admission). This strength, combined with a concussion made me act loopy enough to convince my wife they had missed a subdural and dragged me back to the ED (it was bad enough I fell out of a chair in the ED waiting room). I got a very odd look when I asked for "Motrin, Ultram, anything but more Vicodin..."