IM dilaudid | allnurses

IM dilaudid

  1. 0 In our ED, we have a flowsheet for pts who are given dilaudid, we must monitor vitals Q15 minutes until pt is stable. I have completed these sheets on IV and IM admin routes, but I worked a night shift today and my charge nurse was giving IM dilaudid and discharging pts ASAP. I felt this was a little unsafe, all pts had a ride home but we usually monitor at least 30-45 minutes to see if any adverse reactions. Thoughts?
  2. 8 Comments so far...

  3. Visit  roma4204 profile page
    Like walking out the door right away after or discharging then waiting to leave after?
  4. Visit  Sanuk profile page
    If we had to monitor pts like that after dilaudid, I would spend my whole shift doing VS. We give out dilaudid like candy. Our policy is 20 minutes, one set of VS, and they can go - IV or IM.
    GM2RN and DeLanaHarvickWannabe like this.
  5. Visit  apocatastasis profile page
    Yeah, I find that VS policy pretty ridiculous. How do you determine "stable?" I don't think I have ever had a patient become "unstable" from 1mg IM dilaudid. To be on the safe side, I make sure they have a pulse ox on them and blood pressure cuff to monitor from the nurse's station, but I try to do that with most patients anyway.

    Our ED's policy is to hold 30 minutes after any injection, instituted I believe mainly as a result to ensure no allergic reaction to parenteral antibiotics. We very rarely give IM narcotics just prior to discharge. There are many variables involved in pharmacokinetics, and I can't see that holding for 30 minutes would be sufficient for all patients.
  6. Visit  Anna Flaxis profile page
    We monitor for 20-30 minutes, reassess pain and VS, with no separate flow sheet.
  7. Visit  GM2RN profile page
    We monitor for 15-20 minutes if that is the first shot they have gotten and are to be d/c'd after, but not necessarily for pts who have been in the ED for awhile and have been getting dilaudid, morphine, or whatever all along. And no special flow sheet here either...just chart results normally.
  8. Visit  applewhitern profile page
    We give so much dilaudid, we joke that there is a billboard on the interstate that says "Dialudid~this way!." I always keep them at least 20 min.
    TriathlonRN likes this.
  9. Visit  thelema13 profile page
    Stable as in RR, O2 and LOC. I have not seen much adverse reactions to IM, but a few have passed out right after admin of IV.

    Flowsheet is completed just to monitor VS, usually dont have to do vitals more than x2.
  10. Visit  Murse901 profile page
    We hold for 30 minutes after injection (IM or IV), keep them on the pulse-ox (which is centrally monitored), and d/c them only with a driver.

    If we had to do VS q15 minutes on everyone we gave Dilaudid to, we'd be doing nothing but VS all day.