Dilaudid Question

Nurses Medications

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Hello Everyone,

Just wondering what is the largest dose of Dilaudid you have given IV push??? I know that it is usually 1-2mg but, have you seen it ordered and pushed in greater doses?? Thanks for your time.

Y2KRN

the most i've given is 4 mg dilaudid with 50 mg benadryl ivp q 3 hrs. i did not feel comfortable doing this. on day 2 or 3 b/p started to drop to 83 systolic.

Specializes in Ortho, Case Management, blabla.

I've given 4mg IVP q2h for my entire shift. It made me a bit uncomfortable (we normally do 1-2mg SQ q3h). The only reason I did it was because this was a chronic patient that had been on dilaudid PO at home for over a year and I figured they probably had pretty good tolerance. I was right, they were fine. I should probably add that the dilaudid was stacked onto extended release Oxy 80mg PO q12

Specializes in CVICU, Burns, Trauma, BMT, Infection control.

I've given over 10mg IV doses.You can only push 1mg/minute and it has pretty strong respiratory depressant effects.Anybody on a high dose or PCA should really have a pulse ox in place unless they are opiate tolerant.

Specializes in Med/Surg.

These answers are just incredible to me. ER and PACU give higher doses (and I would say by that I mean like, 1mg at a time), but on the floor we CAN'T give more than 0.75mg per dose. Morphine IV is max of 5mg per dose.

Dang.

On the floor cherry you can't respond as quickly as the ER or Pacu or in my case the ICU, hence the higher doses.

But you get up to 4mg of Dilaudid and then the Docs tell us to start Fentanyl IV and consult pharmD for pain mainagement. PharmD climbs through the pt's history and records and gives us a dose where to start.

But you can tell a big difference, pt's looking for a high hate Fentanyl with a passion becasue there is little to no buzz, pt's in real pain love the stuff, you don't have to worry as much about resp. depression or BP issues. Unfortunately once the pt leaves the ICU they can no longer have the Fentanyl IV.

I just wish I had a magic wand some nights.

I gave 4mg once. Almost fell down. Yikes, that's a whopping dose.

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