Protect Your Patients When Giving Promethazine (Phenergan) - Page 2
Register Today!- Jul 20, '12 by brandy1017Thanks for sharing this important warning! We need to be careful especially when administering vesicants such as dopamine, epinephrine and amiodorone. That's just a few that come to mind, though there are many more. I wish hospitals would insist on using central lines for these medications as is preferred, but to save money, many times only a peripheral lines is used. We need to be careful as we don't want anyone to lose a hand or arm which can happen if these vesicants infiltrate the skin thru a non patent IV.
- Jul 21, '12 by LoqueThanks for a review of the current recommendations and policies. I was quizzed on the difference between using Zofran and Phenergan and besides the drowsiness, this is the most important difference.
- TJ'sMOM likes this.
- Jul 27, '12 by turnforthenurseRNZofran is the drug of choice at my hospital but when that doesn't work, they get switched to Phenergan. IV injection is absolutely not allowed per hospital policy. Some docs have made a fuss but now they know. We only give it PO or by deep IM, and the IM injection still hurts.cherryames1949 likes this.
- Jul 27, '12 by turnforthenurseRNQuote from brandy1017I wish that, too. The only time someone gets a central line put in at my hospital is if they have horrible veins or if we know they're going to be in for awhile. Some patients who didn't expect to be in the hospital for awhile end up being there for awhile, and then by the time they think of putting in a central line, the patient is then ready to be discharged.I wish hospitals would insist on using central lines for these medications as is preferred, but to save money, many times only a peripheral lines is used. We need to be careful as we don't want anyone to lose a hand or arm which can happen if these vesicants infiltrate the skin thru a non patent IV.
It's scary administering vesicants through a simple peripheral IV!
cherryames1949 likes this. - TJ'sMOM likes this.
- Jul 30, '12 by whichone'spinkThank you for this article. I've given Phenergan once as a student, diluted in 10 mL NS of course! I've not given it in IM form, yet. How much NS would be needed to dilute IM Phenergan? And is it best to use the gluteal muscles over the vastus lateralis when giving IM Phenergan?
These are the topics needed more than "My Preceptor is a Bully", or "Old nurse vs. new nurse". - Jul 30, '12 by zero.I learned my lesson with phenergan the HARD WAY.
During those days of giving it via slow IV push, I had one patient who immediately went into seizure, turned out to be a TIA and it really got me anxious and couldn't get over it for a week.
I would never forget how I felt that day. - Jul 31, '12 by TheCommuterQuote from whichone'spinkNobody dilutes IM Phenergan in clinical practice. You give it deep IM, and you must use a needle that's at least 1.5 inches long. Never give it subcutaneously because it will cause damage. When injecting, always give it deep IM.I've not given it in IM form, yet. How much NS would be needed to dilute IM Phenergan?
Quote from whichone'spinkYou'll be fine as long as you remember to give it deep IM. Personally, I do not like using the gluteal muscles because I am always afraid I'm going to hit the sciatic nerve with the long needle.And is it best to use the gluteal muscles over the vastus lateralis when giving IM Phenergan?
Quote from whichone'spinkI certainly agree with you on that point.These are the topics needed more than "My Preceptor is a Bully", or "Old nurse vs. new nurse". - Jul 31, '12 by GitanoRNi learned my lesson many moons ago, and since then i always suggest to give it deeply im.