In my ER, we're required to do preg tests before giving Toradol. Does anyone else do this?

  1. I've only been in the ER for 2 months, but curious to other's reply to this. In my ER, we're required to do preg tests on all females (unless they've had a hyst) before giving Toradol. Does anyone else do this?

    Last week I had a pt come in with alot of pain, and my doc ordered Toradol for her. I decided to go ahead and draw it up, but my coworkers argued with me stating I absolutely couldn't give it until we ran a preg test, my doctor overheard the argument and stated to go ahead and give it and that he's never heard of this rule.

    Thoughts? Comments?
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  2. 21 Comments

  3. by   mkjh
    We do HCGs before Toradol. Rarely give it to women though.
  4. by   Anna Flaxis
    It is my understanding that NSAID use during pregnancy has been linked to an increased risk of miscarriage, and that NSAIDs can cause premature closure of the ductus arteriosus when given in late pregnancy.

    Therefore, it would seem prudent to check an HCG prior to administration of Toradol.
  5. by   LynnLRN
    I given toradol all the time on the med-surg floor I work on and have never checked a pregnancy test.
  6. by   Murse901
    Never heard of it. Not to say that I've heard of everything, though.

    However, a quick Google search pulled this up:

    http://www.drugs.com/pro/toradol.html: "In late pregnancy, as with other NSAIDs, Toradol should be avoided because it may cause premature closure of the ductus arteriosus."

    It only mentions late pregnancy. While there are cases of ignorant people not knowing that they're pregnant until they deliver, I think it's a little overly cautious to do an HCG just to make sure that someone isn't in late pregnancy before you give Toradol.
  7. by   Pixie.RN
    We check HCGs on women before Toradol in my ER.
  8. by   BuckyBadgerRN
    Quote from ReWritten
    I've only been in the ER for 2 months, but curious to other's reply to this. In my ER, we're required to do preg tests on all females (unless they've had a hyst) before giving Toradol. Does anyone else do this?

    Last week I had a pt come in with alot of pain, and my doc ordered Toradol for her. I decided to go ahead and draw it up, but my coworkers argued with me stating I absolutely couldn't give it until we ran a preg test, my doctor overheard the argument and stated to go ahead and give it and that he's never heard of this rule.

    Thoughts? Comments?
    I was given Toradol in ER for kidney stones. They asked if I could be pg and that was it. (clearly, I was not, LOL) As much pain as I was in though, I would NOT have wanted to spend ANY extra time waiting to POAS!
  9. by   swede_33
    NSAIDS generally contraindicated in pregnancy -- especially in the third trimester.
  10. by   nuangel1
    hcg before toradol in my er too .hcg comes back quickly.
  11. by   Anthonyrnbsn
    We definitely do not have an hcg before toradol policy. Thank God because that would delay discharge even more especially in fast track where we want to treat and street ASAP
  12. by   BuckyBadgerRN
    Quote from nuangel1
    hcg before toradol in my er too .hcg comes back quickly.
    LOL, NOTHING happens quickly when you are writhing and vomiting from the pain of a kidney stone---NOTHING
  13. by   momof3lv
    I work in a clinic and have never checked an HCG before giving toradol. Maybe we should be though.
  14. by   mwboswell
    Yes, all NSAIDS are limited in pregnancy.
    Toradol (ketorolac) is a "C" in 1st and 2nd trimesters and "D" in 3rd trimester.

    ...however, besides that fact, ANY female pt who has the possibility of even getting a prescription at d/c, should have a documented pregnancy test. There are few category "A" (IE: safe) meds in pregnancy. So even when they come in w/o an abdominal problem, just the fact that your MD/NP/PA might write a Rx - go ahead and get the preg test. It only takes one bad outcome to make a bad day.

    -Mark Boswell
    MSN FNP-BC CEN CFRN CTRN CPEN NREMT-P
    "Support CEN Certification and Your Local ENA"

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