Protect Your Patients When Giving Promethazine (Phenergan) - page 3

Promethazine is a widely-used medication in healthcare facilities because it has multiple uses. It contains antiemetic (anti-nausea), sedative, antihistamine, and anti-motion sickness properties and... Read More

  1. Visit  turnforthenurseRN profile page
    1
    Zofran 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.
  2. Visit  turnforthenurseRN profile page
    1
    Quote from brandy1017
    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.
    I 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. It's scary administering vesicants through a simple peripheral IV!
    cherryames1949 likes this.
  3. Visit  GitanoRN profile page
    1
    once again another great article form the commuter.... mahalo & aloha~
    TJ'sMOM likes this.
  4. Visit  whichone'spink profile page
    2
    Thank 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".
    E.niles and zero. like this.
  5. Visit  zero. profile page
    0
    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.
  6. Visit  TheCommuter profile page
    0
    Quote from whichone'spink
    I've not given it in IM form, yet. How much NS would be needed to dilute IM Phenergan?
    Nobody 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.
    Quote from whichone'spink
    And is it best to use the gluteal muscles over the vastus lateralis when giving IM Phenergan?
    You'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.
    Quote from whichone'spink
    These are the topics needed more than "My Preceptor is a Bully", or "Old nurse vs. new nurse".
    I certainly agree with you on that point.
  7. Visit  GitanoRN profile page
    0
    i learned my lesson many moons ago, and since then i always suggest to give it deeply im.
  8. Visit  dirtyhippiegirl profile page
    2
    Why not give as a suppository vs. IM? I've personally had both and they tend to act within the same time frame.
    mhayward17 and cherryames1949 like this.
  9. Visit  garnetgirl29 profile page
    0
    My clinic gives a lot of phenergan IM. This is my first job & I don't think we covered phenergan IM in school. The only IM's I gave in clinical were vaccines to the deltoid. So, that was my go to site for phenergan IMs. We have a lot of very thin people & I'm always worried that I may go too deep?? I always aspirate & have never pulled back blood. The first client who asked me to give it gluteal had the boniest hiney I'd ever seen! I was so nervous about the sciatic nerve. I've never attempted using the vastus lateralis. I always thought that was more for children.

    We don't do IV's & when I give the option of suppository or IM, they always choose IM.

    I know IM's require at least a 1 1/2" needle, but what gauge do you normally use for phenergan? I've been using 25.
  10. Visit  TerpGal02 profile page
    0
    I never ever give IM Phenergan in the delt. Always in a large muscle where I can get nice and deep. Usually the DG or VG site. FYI though if you work with any psych pts on antipsychotics and a history of EPS. Phenergan can cause EPS. Happened to me last week. PT became so dystonic I thought she was stroking out on me.


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