Change in IV Phenergan Policy

Side note:
Our formulary requires that orders for Zofran be changed to 4 mg IV Q12 hrs X24 hours. Then, Zofran falls off the MAR and cannot be pulled from the Pyxis. The hospital changed the protocol due to price. This means you can only give Zofran X 2 doses before it is automatically discontinued. That is acceptable for post-op nausea and vomiting, but not too practical for other causes.

I've seen that picture of the hand, destroyed by a phenergan injection. I think the gist of the article that went with it was: Don't inject into anything less than a #20, and don't inject into an IV situated in a hand. Always dilute (the pain itself probably makes most nurses do this). And pay attention/investigate if a patient reports continuing pain at the site of a phenergan injection.

We still give it, but with the above conditions.

HTH

Sure wish they'd make Zofran as cheap as phenergan. Presto, no probs.

I don't even use it anymore.....risk of loosing a limb for using an antiemetic......

I took care of a patient who had phenergan given through an infiltrated IV in her hand. She didn't lose the hand, but required extensive reconstructive surgery. It had eaten through to the bone ...

When I was a patient (on my own unit), I requested that my phenergan be given p.o. An LPN I worked with on nights came in with a vial, got totally bent out of shape when I balked, and so I told her ok, but dilute it and push it VERY slow. The next thing I know, I feel a horrible pain from my wrist to shoulder and see her pull the 3cc syringe out of the port. She had rapidly straight pushed it into my IV undiluted. I swore a blue streak and asked her what the **** had she done... she said "well it dilutes in the IV tubing" and then left the room because she knew how angry I was...

I remember thinking I was going to die; my respirations were gasping, I couldn't speak. I truly have no idea how long this went on. It felt like forever. I remember our tech taking my BP and freaking because it was 70's systolic.

I ended up with a serious case of phlebitis in that arm, swelling to twice its size.

I tried to talk to her and tell her what her mistake was, but all I got was excuses of how busy she was, how she didn't have time to stand and slow push meds, etc. I ended up reporting her to the director. I was ok, but I had to let them know as she could seriously hurt another patient with her ignorance.