Non opioid pain options - page 4

I am on a med surg floor and recently I've had two occasions where patients were admitted to the floor and then asked for pain meds, both had been given dilaudid in the ED and that was the only prn... Read More

  1. by   Been there,done that
    Many patients are on blood thinners , they should not have NSAIDS. Dilaudid is given in the ER to shut them up. (treat 'em and street 'em). Once they hit the floor the prudent nurse assesses the patient ..and goes from there.
  2. by   NurseSpeedy
    So many of the patients that come through my hospitals ER have a history of Hep C or ETOH that unless they checked their liver enzymes before treating their pain I could see why the ER doc opted for 0.5mg of Dilaudid before sending them to the floor to be admitted instead of Tylenol. Years ago I had a few patients with Hep C...now, honestly, its over half of my assignment. Add diabetes and vancomycin to stress the kidneys...unfortunately what other options do we really have? Dilaudid is a bit overkill, but we are pretty much limited to narcs when Tylenol and NSAIDS are taken off the table.
  3. by   MunoRN
    Quote from NurseSpeedy
    So many of the patients that come through my hospitals ER have a history of Hep C or ETOH that unless they checked their liver enzymes before treating their pain I could see why the ER doc opted for 0.5mg of Dilaudid before sending them to the floor to be admitted instead of Tylenol. Years ago I had a few patients with Hep C...now, honestly, its over half of my assignment. Add diabetes and vancomycin to stress the kidneys...unfortunately what other options do we really have? Dilaudid is a bit overkill, but we are pretty much limited to narcs when Tylenol and NSAIDS are taken off the table.
    There's no reason why patients with Hep C can't have any Tylenol. There are recommendations to limit Hep C patients to 2 Grams per day when taken continuously. For chronic liver failure in general there is also no reason to completely avoid Tylenol, it should be avoided in those with severe, acute liver failure, which are pretty obvious just from looking at them.
  4. by   NurseSpeedy
    Quote from MunoRN
    There's no reason why patients with Hep C can't have any Tylenol. There are recommendations to limit Hep C patients to 2 Grams per day when taken continuously. For chronic liver failure in general there is also no reason to completely avoid Tylenol, it should be avoided in those with severe, acute liver failure, which are pretty obvious just from looking at them.
    This is good to know. In reason years I've gotten used to being denied even a single order to get a temp down on a patient and their history is the rationale that I'm given for the reason. So I usually get a low dose of ibuprofen to help bring it down instead.
  5. by   BostonFNP
    Quote from NurseSpeedy
    This is good to know. In reason years I've gotten used to being denied even a single order to get a temp down on a patient and their history is the rationale that I'm given for the reason. So I usually get a low dose of ibuprofen to help bring it down instead.
    Benson, G. D., Koff, R. S., & Tolman, K. G. (2005). The therapeutic use of acetaminophen in patients with liver disease. American journal of therapeutics, 12(2), 133-141.

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