Narcan

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Just a question:

A pt with morphine infusion has respiratory depression, say

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Specializes in ER.

Stop the infusion. You don't want to leave the offending drug running happily along, causing further problems. It only takes a second to stop the infusion before doing anything else that needs done.

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Specializes in Psych ICU, addictions.

I agree, stop the infusion first.

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Specializes in long-term-care, LTAC, PCU.

Stop the infusion. (It takes only a few seconds). If you don't stop the infusion, then what's the point of giving narcan in the first place.

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Specializes in ER, Acute care.

if a pt has resp below 7 you are going to stop the pca and administer narcan, especially with geriatric clients. remember one of the first rulse of administering narcs is count resp before and after. i have been a situation where i was the float nurse because i work er and acute care. well this one pt was lethargic, resp were decreased, family members said the pt had been like that all day. i immediatley went to the charge nurse and requested narcan now, the reversal worked and the pt became arousable, the nurse assigned that pt just thought it was anesthesia, not the case. anytime there is a cont. or demand pca with demerol or morphine, narcan should be taped on the pca or near by for easy access. that is just one case i can remember.:p the reason narcan should be used is the reversal of accumulation of narc. in the body, you want your pt's breathing........

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Specializes in Anesthesia.

Stop the infusion, stimulate the patient, and provide supplemental O2. Narcan should almost always be the last therapeutic thing you do. Narcan is only going to last about 20-60 minutes where the respiratory effects of morphine will probably last at least 2-4hrs. If you use narcan plan on redosing every 30-60 minutes or starting them on a narcan infusion for several hours.

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Specializes in ER, Acute care.

You are correct.....................:yeah:

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Specializes in ER.

And good lord, be ready for them to go KOO-KOO on you:uhoh3:

They seem to leave that very important tid-bit out in school....as a new grad I had this vision of the overly sedated pt gently responding and increasing respirations...UH-UH.! :no:After my first time giving it I thought, "WHAT HAVE I DONE?" and quickly decided narcan was the devil. Boy that woman could SCREAM!

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Specializes in Anesthesia.

I posted this over a year ago, but it is good to think about these things when you are considering giving narcan.

"Here are things to think about when giving Narcan (besides short half-life).

Side-effects of Narcan:

Abrupt reversal of narcotic depression may result in nausea, vomiting, sweating, tachycardia, increased blood pressure, tremulousness, seizures and cardiac arrest In postoperative patients, larger than necessary dosage of naloxone hydrochloride may result in significant reversal of analgesia and in excitement."

When a patient really needs narcan you shouldn't hesitate to give it, but you should also titrate it to effect ie. give just enough Narcan till you have reversal of respiratory depression.

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