We have to call the surgeons and ask for toradol when the patient is not pain controlled. A majority of our patients are over 65, so they don't often prescribe it. That and toradol carries with it the risk of renal failure which we all know is a common complication after cabg surgery, esp. on pump. Basically though, our unit uses morphine on post op patients, and then we taper them to darvocet when they are walky talky. If they're able, and in a lot of pain, we give toradol, but the surgeons are real stingy with handing out anything else for pain medicine which upsets a lot of nurses.
When a patient is out of control, what does everyone else use for sedation? We have a standing order for versed if patient is not early extubation candidate, though the surgeons hate it, and often d/c it when the orders reach us. We use diprivan as a very very last resort. mostly they will use fentanyl, but patients always build a tolerance to fentanyl, and we end up going up on it if they are still out of control. but surgeons don't often realize that sometimes we can't do anything more when the patient is climbing out of his restraints.
|
Would you like to comment?
