wrong route phenergan?

[cybernurse614]

I work at a OB/GYN clinic. I am a new RN and was asked to give phenergan IV push into already started IV. I asked the doctor if I should give the medication IM rather than IV after being warned of possible complications. The doctor wanted IV and I was advised to go slow. I diluted 25mg in 10ml 0.9% NS. The tubing used in our office requires needles for injecting into the port which I was unfamiliar with. I used a saline lock and administered over 10 min. Then restarted the IV to finish off last 500ml of LR. Patient had no complaints of pain, redness or tenderness. Now I am reading about all the complications and freaking out! Any advice would be helpful. Am I overstressing out?

[GeauxNursing]

Needle systems are illegal.....aren't they? I thoguht it was law by now. What compoany tubing are you using, surely then make an adapter.

Nope, we give our meds using a needle into the saline line every day.

[NightNurseRN]

We give phenergan IV all the time. Never experienced a problem myself.

[IVRUS, BSN, RN]

Just not worth your license to push this drug IVP! Risks are too High!

I just did a case study on phenergan for my pol. Sc. class, guess what nurses, we are incorrect about Phenergan!Just this march 2009, this case went to all the way to the Supreme Court. I was horrified to learn that all these years I had been giving phenergan Ivp as instructed by my policies at each of the facilities I worked in. I learned doing this research that if I push Phenergan iv push, as I am instructed to do by md's orders. I will be sued, if an adverse reaction occurs, Phenergan is so bad that if the iv get inflitrated and the drug enters into the tissue or artery, gangrene can and will develope. They will amputate the limb as far as they need to. Nurses be aware that phenergan is a very dangerous drug, do not ivp the drug, do not dilute it in 10cc normal saline, diluting it in 10cc is not safe enough, dilute it in 50cc - 100cc of saline and hand that bag. I can't tell you enought times do not ivp the drug, even if you flush the line or check it right before the push, you can't assume nothing will happen in those few second that you decided to push the drug that it was patent. We are mislead thinking we're going to alright pushing phenergan, don't do it! It just one time... the patient has the right and will sue the hospital, doctor who orders it, and YOU, and the patient will be right in doing so. By the way, she was mean because the you hurt her either because you pushed to fast, or the iv was inflitrated, phenergan hurts going in. Consider not pushing at all.

Most issues with lawsuits involving IVP phenergan occur with short term peripheral IV catheters (less than 3 inches in length). Phenergan is a vesicant, but if you have a patent central line, there is no reason not to give it via this type of IV catheter. Yes, I'd still do a 1-10 dilution, but giving it centrally makes all the difference in the world.

The smooth lining of the inner lumen of the blood vessel is comprimised quickly with the administration of irritant and vesicant drugs. This stems from the fact that the blood flow in the peripheral vasculature is not what is seen in the central venous system.

[shrimpchips, LPN]

I have given Phenergan IVP several times without any problems...

[sasha2lady]

hmm....this is new to me also....takes me back....when i was 18 yrs old I got an awful case of food poisoning and ended up in the er....well...i was soooo miserable and sick..anyway...a nurse came in with a syringe....and told me it would help w/ my vomiting...so...she pushed it in my iv....she didnt go slow and ohhhhh myyyyyy godddddddd.....did it set me on FIRE!....my entire arm all the way up to my face and head and neck felt like it was on fire from the inside out. I dont know what the mg was but i remember the syringe was small...like a 6 cc syringe. I remember laying there and looking up at the lights and i tried to turn my head....i was out almost instantly. then someone came and woke me up and told me to get dressed that i could go home...i made it to the sink and hit the floor but luckily i never felt a thing. ......makes me wonder how much she gave me and if it was diluted in anything?

[OldnurseRN]

We never give phenergan IVP. It is always mixed in a 25 ml or 50 ml bag of NaCl and dripped.

[Zookeeper3]

Phenergan IV is automatically exchanged for zofran per our hospital therapudic interchange. For about 6 months, no phenergan IV can be given through a PERIPHERAL line. We are allowed to slow IVP once diluted through central lines/swan. This route is sure to be on the "list" soon. Its like vasopressors, sure you can give them peripherally, but why risk it.