IV Magnesium Sulfate in office??? - page 3

Is it safe to administer 1 gram IV over 30 minutes to migraine patients with no monitoring and no baseline levels? Having a meeting today with our supervisor to disuss this. If you know of any documentation I can present to... Read More

  1. 2
    When I give Mag in the ER it is most often a component of treatment for varying degrees of respiratory distress. 1g given over 30 min. ... 2g given over one hour. For severe asthmatics who we are REALLY TRYING HARD not to intubate, I've run it in faster -- that was in fact protocol at one hospital where I worked.

    I can sense your genuine concern in your posts, OP, but I'm not understanding the basis of your concerns. And I bow down and applaud office practices which are willing to employ appropriate staff to perform these interventions in an office setting, rather than the all-too-often default mode of many PCP offices, which is: go to the ER.
    psu_213 and monkeybug like this.

    Get the hottest topics every week!

    Subscribe to our free Nursing Insights newsletter.

  2. 0
    Quote from Altra
    I can sense your genuine concern in your posts, OP, but I'm not understanding the basis of your concerns. And I bow down and applaud office practices which are willing to employ appropriate staff to perform these interventions in an office setting, rather than the all-too-often default mode of many PCP offices, which is: go to the ER.
    ^^This!!

    My physician spends most of his office hours running infusions on patients in an effort to keep them out of the ER. Most ERs undertreat/mistreat migraineurs (I've been told "Headaches don't get IVs!). It costs me an arm and a leg every time I go, but so worth avoiding a trip to ER hell.
  3. 0
    Quote from monkeybug
    ^^This!!

    My physician spends most of his office hours running infusions on patients in an effort to keep them out of the ER. Most ERs undertreat/mistreat migraineurs (I've been told "Headaches don't get IVs!). It costs me an arm and a leg every time I go, but so worth avoiding a trip to ER hell.
    I agree with you. While I've had really, very excellent luck with hospital ERs in relation to my migraines, my fond hope and dream is always to manage them outisde of that setting. ER free for the past three years but it isn't always easy, and any new modality that might work is great.
  4. 0
    As we become more accountable this will be come more common practice. an ER is not an appropriate place for migraine. its not cost efficient , much better to manage that in an office setting.
  5. 0
    Quote from evolvingrn
    As we become more accountable this will be come more common practice. an ER is not an appropriate place for migraine. its not cost efficient , much better to manage that in an office setting.
    I agree with you up to a point. Status migrainous is dangerous and needs to be treated. And there is such a thing as migrainous stroke from untreated or mistreated migraines. My neuro is in another state, and we have been unable to find anyone willing to do infusions on me here in collaboration with him. Not home health, the local pain clinic, or the nearest infusion center. Some times I have to go to the ER, and I hate it. If I'm there, it's because I've absolutely gotten desperate.
  6. 0
    According to the IV drug monographs I use for work, it's acceptable to administer mag sulfate without any monitoring as long as the rate does not exceed 2g/hr and it is not an OBS case. Your 1g over 30 minutes falls into that acceptable range. I would still see what the drug information says in your area, however.
  7. 0
    Primary care providers in my area send patients to the ER all the time for a dose of mag or potassium. The ER sends them to med-surg and we administer the mag or whatever and then send them home. They are usually on the floor for a couple of hours. It seems awfully expensive for something that could be addressed in the office. We've had the same patient come in 2 weeks in a row for a mag infusion. I don't mind either way, they are usually the easiest patients to care for...but from a cost point of view, I would think the office would be cheaper.


Nursing Jobs in every specialty and state. Visit today and Create Job Alerts, Manage Your Resume, and Apply for Jobs.

A Big Thank You To Our Sponsors
Top