i had a patient who was admitted for medical reasons. this patient had an extensive psych history. i finally got admission orders and pain medication 4 hours after the patient had arrive to the floor. i medicated the patient with dilaudid 2mg iv. it was iv pushed over 5 minutes. the policy at my work place allows dilaudid 2 mg iv to be iv pushed in 2-3 minutes. in a couple of minutes,the patient's eyes closed, tacypnea, pupils dilated & slowly responive to light, and became nonverbal. to make it short... i gave narcan 0.4mg iv and was not effective. ativan 0.5mg iv was given and was not effective. benadryl 25 mg iv was given and was not effective. i had to transfer this patient to the icu because of hyperventaliation.
i was simply medicating my patient for c/o pain. this was the first dose given. i don't know what happen. is there an interaction between seroquel and dilaudid? did dilaudid trigger something neuro wise like the neurotransmitters? was it an allergic reaction? or dilaudid was too much for the patient eventhough the adverse effects were opposite of narcotics?
