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

This poor patient is getting Demerol *and* Phenergan in those doses IV??! For *how* long??! OUCH!! For one thing, he needs a central line or PICC for IV therapy if he's going to need it for more than a week or 10 days; for another, he needs another form of pain relief. Please speak with his doctor about changing it.......I'm surprised he has any veins left after a week of this!

I would put the phenergan in a soluset , piggyback, buretrol or however you want to dilute it.

I would think the Dem/Phen should be IM if he is getting it every 4 hours, we would use that as an IM schedule. I would expect the patient to need it every 4 hours if they are getting it IV. The half life of an IV med is shorter than IM therfore the dose isnt going to last the 4 hours. I would ask Dr to either put him on a PCA with a prn dose of zofran or soemthing,, or ask him to change the route. Most IV doses ive seen are either q1 or q2 hours, and are prn. I dont know what kind of surgery/illness this is being given for but some questions need to be asked if he is requiring it that often. Both for the nurses convience and the patients. Its not fair to the patient to have to ask for pain med q4 hours round the clock when we have PCA's available.
Now that i think about it, we rarely give 75 IV and 100mg doses are usually only given as preop after they go to holding, and they sure arent given for a week.

I've only seen that order on our med-surg floor for IM Demerol and Phenergan-- NEVER IV. We're not allowed to give any more than Demerol 25 mg IV push on our floor at a time anyway.

He graduated from Morphine to Demerol? What about Dilaudid?

Demerol- yuck.

Demerol and Phenergan, you'd almost have to mix them in 100cc and hang them like an antibiotic.

We have great luck with Tylenol 1G Q6H to decrease narcotic needs, or a scheduled antiinflammatory.

I usually dilute demerol and phenergan with about 10 cc's.

But 50 mg of phenergan is too much to give IV. I don't have a resouce but isn't the max recommended dose for IV only 25?

As stated earlier this should be diluted in 100 cc of NSS and given as a PB over hour.
This patient should have a PCA. He should be on a antiinflamatory agent. Most of the ortho doc's here give Toradol IM in the PAC unit and give 2 more doses IM every 8 hours, this help with inflamation.
Why is this guy not getting po pain meds for break through pain. A crushed patella IS painful, seems like a pain management specialist should be called for some input.