[RARRN]

I was recently on shift in an ED when physician ordered IV versed to be mixed with PO tylenol and given to a pediatric patient for conscious sedation to reduce closed fracture of forearm. The label on the IV Versed read "for IV or IM use only". I showed the physician the warning and he replied, "we do it here all the time." I informed the physician that I was uncomfortable giving the medication and gave the order to my charge nurse who carried out the physicians request. The rationale on the box was because it contained a certain type of alcohol that was not for po ingestion. Have any of you ever used this drug orally?

[MeghanRN]

I've used PO Versed many times to preop children.

That said, Versed comes in 2 forms - IV and PO.

The child should have received PO Versed and not an IV versed by mouth. I'm sure if the pharmacy stocks IV Versed, they should have some PO.

Sorry, but to me, thats bad practice on the nurses and drs part and you were very right to refuse to give it. They should have gotten the correct form of the drug before administering PO. I actually think that the issue should be taken up with the MD...or higher..

[nuangel1]

i agree .you did the correct thing .iv versed is for iv use .if this is the policy in your ed then they need to use po versed and have a written policy for it .you need to go up the chain of command .

[RN29414]

In outpatient settings, such as physician's offices, IV versed is mixed with tylenol for pediatric sedation. You can do an internet search and find the formula. It is important to use the 1mg/1ml form and not the 5mg/ml. It is not bad practice, just using what is available. Many formularies do not carry po versed unless they have a PICU or Peds ER.

Mary

[steelcityrn]

It may be done, but if a child were to have a bad reaction to that and was injured, a lawyer would be all over that since the bottle states IM or IV.

[canoehead]

Our pharmacist says po is fine for the IV med, it just isn't mixed with any sweeteners. We have also used the IV form intranasally.

[anononurse]

I have done it many times w/peds, sometimes mixed w/a little apple juice-- seems to go down easier than the syrupy tylenol & easier than the po versed too. The job I'm at now uses only the PO Versed liquid for kids though.

[teeituptom]

works well, look outside the box.

[bigreddog1934]

if using it for this purpose is so common, why doesnt the pharm just stock it in the po form?