Pain meds IV push

[krista312]

Hi all,

i just started at a new hospital and am still on orientation there I came from a smaller suburban hospital where for people in acute pain such as post op pain iv pain meds would be pushed as long as it was in accordance with hospital policy the other day at the new hospital I am training at I had a pt who was sp TLIF procedure in excruciating pain so after checking the hospitals policy for iv morphine I pushed the med into the pt's iv a bit later the nurse who was orienting me that day asked how I gave the morphine and insisted that they was its done there is to put it in a 50ml bag of NS or D5W and hang IVPB to me it seems silly! I'm wondering what your practices/ policies are in other facilities ?????

thanks!!

[txspadequeenRN, BSN, RN]

if i gave morphine like that ..thats all i would do is hang piggy backs...especially with all these q1 or even q 30 pushes.....

[LouisVRN, RN]

I would worry about leaving a narcotic in a 50 cc bag and leaving it unattended. Even if I have to push a med slowly it will take maybe five minutes not the fifteen minutes a 50cc bag would take minimum. Unless it is in some kind of lock box what is to stop the pt from siphoning the med out storing it and collecting a large quantity and self administering it. If this is your policy I would highly recommend trying to find some ebp and changing policy

[elthia]

if i gave morphine like that ..thats all i would do is hang piggy backs...especially with all these q1 or even q 30 pushes.....

with my patient population, i'd be worried about the fluid overload....i have some that get q1-2 pushes but are end stage heart failure...that would be a heck of a lot of fluid.

[Jenni811, RN]

ours is pre-drawn up for us and we can just push it, no diluting necessary. 1mg/minute for morphine.

the 50cc may not be good for patients with certain cardiac or pulmonary conditions (i.e. CHF or Pulmonary Edema). That 50cc doesn't seem like alot, but when your doing it every 1-2 hours, it adds up.

[TriciaJ, RN]

if i gave morphine like that ..thats all i would do is hang piggy backs...especially with all these q1 or even q 30 pushes.....

morphine q1h or q30"? what a nuisance! what your facility saves on pcas you're spending on shoes!

[diva rn, BSN, RN]

Morphine Q1h or Q30"? What a nuisance! What your facility saves on PCAs you're spending on shoes!

Not if your patient is not alert or cognisant enough to use a PCA...and yes, they can be in pain and "not alert"...so cost is not always an issue.

[wooh, BSN, RN]

Even without an on demand dose, PCAs are nice to put someone on a continuous dose.

[TriciaJ, RN]

Not if your patient is not alert or cognisant enough to use a PCA...and yes, they can be in pain and "not alert"...so cost is not always an issue.

I know. Elderly folks often had trouble getting the hang of a PCA, even if they were cognitively intact. I was lucky enough to work with a population for whom PCAs were usually a godsend. I did float to other units where PCAs were not commonly used - exhausting!