MORPHINE OR OXYGEN?

  1. Can someone please tell me which to give first during an MI...the O2 or the Morphine? I'm looking over my notes from school, and I learned to always give oxygen first; but I've read a few places to give the Morphine first because it decreases the oxygen demand.
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  2. 20 Comments

  3. by   elmed
    According to latest treatment of American Heart Association:When a client in the ED with ANY form of chest pain give them an Aspirin and put on Oxygen.

    #1. O2
    #2. Nitro
    #3. Morphine

    Not long ago it was MONA- Morphine, Oxygen,Nitroglicerin, Aspirin. Now , order is: O2,Nitro, Morphine.
  4. by   WEST1014, RN,BSN
    Quote from elmed
    According to latest treatment of American Heart Association:When a client in the ED with ANY form of chest pain give them an Aspirin and put on Oxygen.

    #1. O2
    #2. Nitro
    #3. Morphine

    Not long ago it was MONA- Morphine, Oxygen,Nitroglicerin, Aspirin. Now , order is: O2,Nitro, Morphine.
    Thank you.
  5. by   caliotter3
    Also, look in your review book. It should emphasize the latest accepted policy.
  6. by   nursebeckyslc
    I have the MONAA (with an extra A for antiemetic) in my notes...I understand that it may have changed but how long does it take for NCLEX to update their ?'s?
  7. by   Little Panda RN
    I just graduated in May and everything I was taught was to administer the morphine first. Morphine decreases oxygen demand on the heart. In school we did use MONA as the standard protocol for an MI. Every question I got concerning an MI and what I would do first, the answer was always morphine.
  8. by   butching15
    what shoud be the right one?
  9. by   Little Panda RN
    Here is a link to another thread last year here on allnurses concerning this exact same question. MONA

    It can be confusing to say the least when different references give different information. If I get a question like this on the NCLEX I will answer morphine as my first choice.
  10. by   TinyRNgrl
    During a MI think of what is happening to the heart. It is being deprived of 02, it takes two seconds to put the patient on oxygen and I am going to put my patient on oxygen while I go get the morphine and give it to the patient. MONA is a mnemonic of what to do with a patient with chest pain...M morphine, O oxygen, N nitro, A aspirin. This is not exactly the order in which to treat your patient because I will give nitro before morphine and I will ALWAYS put oxygen on my patient first.
  11. by   souleater11
    [font=verdana, arial, helvetica, sans-serif]hi guys, i would like to know the latest 2012 guideline of american heart association regarding priory of oxygen vs morphine.

    [font=verdana, arial, helvetica, sans-serif]if anyone knows pls feel free to post the weblink here.

    thanks
  12. by   diana2520
    Quote from souleater11
    hi guys, i would like to know the latest 2012 guideline of american heart association regarding priory of oxygen vs morphine.

    if anyone knows pls feel free to post the weblink here.

    thanks
    you always give oxygen with an im, mona is a guide or mnemonic, to help us remember , what we can give (got this from hurst)
  13. by   souleater11
    thanks but if there is a priority question. which is select first. Oxygen or Morphine?

    pls bare in mind that I looking for the latest update on this issue.
  14. by   Double-Helix
    Oxygen is absolutely first.

    Think about it logically. A patient comes into the ER with heart attack symptoms. In order to apply oxygen (which can be done without a doctor's order) you need to grab the mask from the wall and put it on the patient.


    In order to give morphine you need to: 1. Start an IV. 2. Get an order. 3. Get the med from pharmacy or the Pyxis. 4. Draw it up and administer.


    Yes, morphine decreases oxygen demand. But what is more effective? Increasing available oxygen or decreasing oxygen demand? If you decrease demand but don't have adequate circulating oxygen then you really aren't helping.

    This original thread is from two years ago.

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