Change in IV Phenergan Policy

They say that JACO is trying to discourage IV Phenergan altogether R/T necrosis, pt. discomfort, and the fact that it can blow the IV line if given repeatedly. I have heard that the suppositories and IM routes are still acceptable.

One local hospital I was actually a patient in, tried to use Phernergan only as a last resort (opting for Zofran or compazine). If the Phenergan was used, it was ALWAYS cut into 20ml NS standard and pushed over about 10 minutes. They stated they thought it would soon be removed from the formulary.

The hospital I currently work at has just gone from diluting Phenergan with 10ml to 20ml and they try not to use it at all in anticipation of it being removed from the formulary.

we still use phenergan, but the docs order us to dilute it in 50ml/100ml of saline and piggyback it into the primary line with a slow drip.

Anyone know what is TOO slow? Reading all this is making me nervous.

Vida

Here's a link to a story and picture of a 19 year old student. Not sure if it's the same story as you mention, but it's pretty powerful.

http://www.thedailyworld.com/article...ews/02news.prt

We are no longer allowed to give phenergan IV push it was actually completed removed off the floor to prevent this. Now we have to get it from pharmacy in a 50ml bag and given over 15min. It is horrible because when your pt has N/V and you have to request the dose from pharmacy and wait an hour to get the medicine pt isnt very happy. The hospital I work at doesnt think much and then wonders why satisfaction is so low.

My hospital wants it diluted in at least 20ml and pushed over 5 minutes. I end up doing almost the same as you: 50ml of NS to 12.5 mg of Phenergan and I run it over 20 minutes (150 ml/hr) on a pump. My hospitals allows nurses to use their own discretion (from a lengthy set of standing orders), but 20 ml is the minimal amount of fluid for 12.5 mg of phenergan.

I always dilute my doses in 20 ml syringes and run it using a mini-infuser. About the only thing I do without the infuser is Toradol (again, diluted because it burns like crazy as it goes in). I use the mini infuser for things like Metoprolol as well.

Does anyone honestly have the time to sit and IVP something over 15-20 minutes?!!

If I had 15-20mins extra I might just eat or use the bathroom for once.

havent seen anything change in either the outpatient pacu or er I work in. I always have given it from the farthest port slowly. I never given it straight IV push into the saline lock.

I just have to say that this post has completely changed the way I give phenergen.
I now give it 6.25 diluted in a 20 ml syringe, very slow push.
I have even brought it up with a few docs after reading this site, and a pharmicist, regarding changes in hospital policies around the nation. The pharmicist was a aware of the new trend, the doc wasn't. I have even spoke with the nurses about..so we all are changing our practices as a matter of course. I love this site!