APPENDICITIS

[KYARNP]

I am curious how your ED treats appendicitits. As a clinician I have my owns set of orders, but curious as to what yours are.

My orders are as follows.

Saline Lock,LR 1 L,MORPHINE 2 MG,ZOFRAN,VANCOMYCIN IV,ANC SURGERY CONSULT.

[Altra, BSN, RN]

What is your rationale for going straight to Vanco as an abx choice?

[Gabby-RN]

The usual orders I see are IV, labs, NS, zofran 4mg, morphine 4mg (adults) x 3 doses, CT, surgical consult. We don't give antibiotics initially and transition to LR only after 2L of NS. We also will switch to Dilaudid if the morphine clearly isn't working.

[KYARNP]

I use Vancomycin as it is our surgeons #1 choice for appendicitis.

[That Guy, BSN, RN, EMT-B]

I use Vancomycin as it is our surgeons #1 choice for appendicitis.

Really? There are much better options out there

[wyosamRN]

Does seem like a strange order for an appendix. Tough on veins and not exactly keeping the big guns for when they are really needed. I've typically seen cefotetan or levaquin + flagyl.

[Christy1019, ASN, RN]

I second the Levaquin and Flagyl, NS, and the higher doses of pain meds

[MunoRN, RN]

CT, R/O sepsis/abscess, pain meds, common gut bacteria antibiotics (flagyl, etc).

We no longer get a surgical consult as part of the standard protocol since we typically no longer move towards surgical interventions in appendicitis as a general rule.

[vintagemother, BSN, CNA, LVN, RN]

We no longer get a surgical consult as part of the standard protocol since we typically no longer move towards surgical interventions in appendicitis as a general rule.

What do you do for appendicitis at your place of work?

[ChristineN, BSN, RN]

Really? There are much better options out there

Agreed. At my hospital we generally give Zosyn for appendicitis. I have never given Vancomycin to someone with an appy, seems like overkill to me.

[JustPeachyRN]

IV, zofran, morphine, fluids (1-2L if lots of vomiting), and typically 1G Invanz prior to OR.

[MunoRN, RN]

What do you do for appendicitis at your place of work?

In uncomplicated appendicitis we use only antibiotics initially, a portion of those will require surgery but for the majority antibiotics is the only treatment required.Appendicitis Treatment with Antibiotics by Dr. Marks on MedicineNet.com