Quote from LindaMarie76
What does the order/protocol for the Fentanyl gtt look like? And why Fentanyl versus Morphine?
There isn't a protocol for the fentanyl, rather an order like fentanyl IV drip 50-100mcg/hr.
Of course with all of these drugs, prop, versed, fent. the dosages can be much much higher depending on the patient's response to them.
I don't know the rationale for using fentanyl over morphine as a drip, except that there is a general feeling by the docs that fentanyl is a kinder, gentler drug...on the elderly especially. We use fentanyl over morphine, I'd say, 80% of the time with plain prn orders.
I would NEVER run a sedative without a pain med. There are some exceptions with neuro patients. For our patients who are fresh post-op hearts who we plan to wake up and extubate within 4-6-8 hours, we don't necessarily have a fent drip running with the propofol as we wean it to off. But we are requried to give prn boluses of narcs as the patient's wake up (they may still be on a bit of propofol as they wake). It's considered unethical to sedate but not cover for possible pain, and most of the charge nurses will get after those who do not give prn pain meds to a sedated patient.