IV Toradol? - page 2

Ok I've researched the web and asked some of the other disciplines in our facility but many of the answers are vague. We have doctors here that are reluctant to give IV Toradol. Some say it "burns... Read More

  1. by   camay1221_RN
    Some of the other standing orders for c-sections were:

    Droperidol 0.625mg q6h prn nausea

    Diphenhydramine 25-50mg q6h prn itching Usually only for the Duramorph pts.
    The pts on PCA's were sometimes gorked enough from the Morphine or Dilaudid.

    The pts also got a self med pack which had ibuprofen, prenatal vitamin, stool softener, and simethicone. They got these only after they were off the IV meds.

    I always hated it when a mom came over from recovery with a basal rate PCA. Most of them c/o of feeling very sleepy. I took that opportunity to offer the Toradol, d/c the basal, with MD orders of course. If pt tolerated it, she still had the PCA button to push, but it was more to her needs.

    Quote from mother/babyRN
    Whew! Thank goodness. I was starting to get a little nervous....Our moms prefer it over morphine iv, which often makes them nauseated....What are your other standing orders? Ours are zofran four mg iv q six hours prn nausea, narcan, pepcid or reglan iv prn and several other things along with nubain for prurits post duramorph spinals, the torradol, droperidol for nausea and whatever else the individual doc wants..
  2. by   RN-PA
    I like Toradol a lot. It's a great addition to narcotics and some of our surgeons order it q6h as a standing order along with prn MSO4 or Dilaudid IV.

    I have had patients complain of burning when administering Toradol IV, even with a running IV and giving it slowly. If a patient has a heplock, I've given Toradol diluted in 5-10 ml NSS to help with the irritation if they've complained about it burning previously..
  3. by   VivaLasViejas
    We give Toradol IV all the time on our med/surg floor.......in my experience, it's one of the most effective drugs around, and I've requested it many, many times for patients with difficult pain-control issues. I push it over 1-2 minutes, have never had a pt. complain of burning unless the IV site itself was going bad. (Of course, I'll dilute it in 5cc NS if I'm pushing it through a saline lock and flush it well afterwards.)

    Personally, I wouldn't have surgery without it, barring any contraindications such as GI bleed. Morphine makes me itch furiously, Demerol merely makes me loopy and nauseous, and Fentanyl doesn't last long enough......give me Toradol any day!
  4. by   barefootlady
    Toradol is given IM in RR post TKR, THR, and other ortho procedures here. Given q 6 hrs after initial dose in RR x 24 hours. Then dcd. Some doctors give it IM/PO after ESWL, Lap Chole, etc. Must not be given with Nsaids or if Ulcer, GI bleed is problem. Some patients love it, others hate it. I have never taken it.
  5. by   pixiel
    We use it quite a bit on the med-surg floor where I work. Many times for kidney stones/renal colic a lot. Also, for many other things too. I have taken it myself and acutally refused the morphine they wanted to give me instead. It worked extrememly well. Yes, it has GI side effects just like other NSAIDS. A history should be taken just as with the use of other NSAIDS. Also, it is not given where I work for more than 5 days and is usually 15 or 30 mg Q6 hours. I tend to push all IV meds slow and no extra flush is required, according to the information I have looked up before giving it.
  6. by   BRANDY LPN
    We have about the same OB orders as everyone else for PO C/S. How much are ya'll giving? I think ACOG just came out with a recommendation for 60 mg Q 6 hours. but we only give 30 mg.

    Edited to add Toradol and phenergan will crystalize LOL lessons learned the hard way stick with ya.
  7. by   Tweety
    The docs may be old school. Initially when IV toradol became all the range it wasn't recommended IV if I remember correctly and only given IM. (At first it was only available p.o.). But as the others have said, times have changed.
  8. by   lady_jezebel
    I work on an ortho med-surg floor. We often give IV tordol as a pain-control adjunct, without problems. However, a pt can have no more than 2-3 doses, since it can kill your liver.
  9. by   z's playa
    Quote from camay1221_RN
    Mother/babyRN,

    Your toradol orders are the same as the ones we used at the PP unit I used to work on. We had one MD who refused to write orders for Toradol postop, but the c-section moms just LOVED it!
    Isn't it not a good idea for post op anything? Especially C sections? Major surgery.
  10. by   kids
    Quote from z's playa
    Isn't it not a good idea for post op anything? Especially C sections? Major surgery.
    I am guessing you are asking this in reference to the increased bleeding times and platelet anti-aggregation properties associated with most NSAIDS and the potential for new onset ulcer/GI bleeding in stressed patients.

    My understanding & experience (as a patient) is that post-op patients are often on an IV or PO H2 blocker and that in an otherwise healthy individual the benefits out weight the potential risks.
    Last edit by kids on Jun 9, '04
  11. by   sharann
    I work with an anesthesiologist who will prescribe 30mg IV Toradol followed by 30 mg IM Toradol (Total of 60mg) for many of our gyne outpatient surgeries and some inpatient general procedures and we find it to be superior to the narcotics AFTER an initial few IV doses of MS, Dilaudid, Fentanyl or Demerol to cut the acute and immediate post-op pain. These pts who get the Toradol(ketorolac) often do great and ambulate earlier, as well as have less nausea. Just my experience with it. We also have an ortho surgeon who has 15 to 30 mg added to each liter of D5LR for the first 48 hours post THR or TKR. Works for them he believes.
  12. by   WOLFE
    where i work with post op cabg pt's...we use it ivp...again check lab values, pt hx, and allergies...according to the pt's it works.
  13. by   rdhdnrs
    Love Toradol!! Same post-c/s orders as Mother/baby RN; never had a problem. We don't give it ASA allergic pts or those who have bleeding problems.

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