50 mg of Phenergan IV push!!!!!!!!!

I definitely understand where you are coming from on that. PCA is designed to administer analgesia in small increments after adequate pain control has been established. Sort of to keep the concentration at a good constant level. Do you usually have orders to administer a bolus if a person has been asleep and wakes up to pain, in order to get them back to therapeutic levels?

We never use a PCA in the ER, so I suppose phenergan works better in that setting.

In the ED the most demerol ive ever pushed was 100mg.. if i remember the order was originally for 150. This was a repeat order! All i remember was that this lady was unmonitored and in the hall...I double checked with the Doc who is a excellent doc.."If your not comfortable with it just give 100mg"...I titrated that over 10 min....She left with SOME pain relief (Seeker)
As for phenergan 25 is the most i will push...slow and with a running IV, reglan is given reg., zofran occasionaly for CA pts and those that wont stop vomiting ( To exp.for the ED)