[LilgirlRN]

There is no policy in my hospital either. Like many of you I learned from personal experience just how badly it can hurt. I had an ulcer last year and was in the hospital for 2 days...had 5 IV's during that time. I've made it my personal crusade to educate other RN's in the ED to dilute Phenergan in at least 10 cc of NS even if you have a running line. We give a lot of Demerol/Phenergan IV, I always give it separately. I give the phenergan first, wait a few minutes and then give the demerol. I've found that I get much less vomiting in response to the demerol that way.

[Lulu]

The first time I pushed phenergan, it was undiluted and as I watched, the web of all the vessels proximal to the site turned red like I was putting red dye in. OUCH!!! Sorry!

[jode]

Dilute with 10cc saline....that stuff burns up veins like wildfire....and according to the patients , feels the same way......

[lisamcrn]

Well, I'm not sure what to think now. I gave my first iv push phenergan just this afternoon. It was given in a central line. The order called for 12.5-25 mg q 6 hours. My drug book indicated to dilute 25-50 mg with 9 cc of saline and to give 25 mg or less/2 mins. The pharmacy instructions on my MAR indicated to dilute the 25 mg and give over 2 mins. Another nurse stated they usually diluted it. I gave the 12.5 mg and with my drug book and the pharmacy instructions as reference I did not dilute this dose and gave over 2 minutes. My pt. had no problems indicated or c/o during or after receiving this.......but, did I really screw this up or what??
Lisa

[chicory]

Always dilute w/9cc's saline where I work. I have often noted confusion in the elderly with this drug. You have to be very careful. Ambien also causes people to flip out at times!
Once when I was a patient in the ER, the nurse pushed phenergan undiluted into my Medlock---I said-hey...stop..dilute that please!! It hurt like hell, and the vein was tender for a few days later. She was irritated w/me, but stopped and diluted the rest of it.

[cactus wren]

I have been one the recieving end of phenergan IV, and yup....it hurts......and I only got 6.25mg. and it was diluted in 10cc, and given through a running IV, and still felt like my arm was on fire, and did have a phelbitis for a looong time after. But it did stop my postop projectile vomiting So now I ALWAYS dilute it, and give it sllooow, and tell patients that this is gonna hurt...........And I have also seen it make that sweet lol get way weird and sometimes hallucinate or get very confused and disoriented.........Will ask doc for something else for the elders.

[KarafromPhilly]

Where the heck are you still giving Demerol?
Meperidine has a nasty metabolite, normeperidine, with a looooong half life. It can cause neurotoxicity, especially in the elderly, and it is not reversible with Narcan. And I thought my hospital was behind the times!

[Sleepyeyes]

We do give demerol, but we try to avoid it.

When ordered, we give it separately from phenergan, as described by Liligirl, above.

[MollyMo]

We run it as IVPB in 50cc NS.

[nursenatalie]

I've had some terrible experiences with Phenergan. I was in the ER in a local hospital after N&V and diarrhea X 3 days which I later found out was Giardia. Anyway, I received Phenergan IV push undiluted...yes it hurt but that was not my major concern. About 5 minutes after the med was pushed (he pushed it in about 20-30 seconds) I became restless and literally could not stop moving my arms and legs. This continued and I began crying and asking the MD what was wrong. He told me that it would pass, well...It did but it took nearly 8 hours. They discharged me after a liter of fluid and sent me home with a script. I continued to have this dyskinesia type movements....It was awful!!! I had received phenergan before with no ill effects but now I say im allergic to avoid the possibility of this, Anyone else ever heard of this? How about the MD who dismissed this reaction? I was too sick to pursue it further at the time but it was really scary!