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nope, not even Tylenol. Most every ER I've worked at has standing orders to to certain things even up to IV narcs and anti-emetics for chest pain, abdominal pain and such and as a RN I can sign those order sheets as a verbal order from what ever ER doc is working but it has to be counter signed by the doc at some point.
If it is an absolute emergency, you can give it without an order. You must then obtain an order after you have taken action.
For example, upon lung auscultation you hear no sounds in one lobe of a lung. This may may well have a pneumothorax. You would immediately elevate the HOB, administer oxygen and then notify the MD/NP/PA, etc.
If patient is having an allergic reaction to an infusion, STOP the infusion and notify after.
In an absolute emergency, the patient's safety comes first. If you took the time to notify the provider first, bad results could ensue. Other than emergencies, you must have an order for everything, unless it is a nursing intervention (elevate HOB, SCDs, TEDs, q2h turns, fall preventions, etc.)
Yeah, that's what I said in my post. You must still get an order for it afterwards, but you do need to administer oxygen first. What if the patient's lungs collapse? What if the MD doesn't answer until after four telephone calls? Meanwhile the patient is steady struggling to breathe.
Not attacking anyone, but I was only stating that at times it is necessary to take immediate action and then notify.
It's walking on thin ice to do so, but in the ER, with many years experience behind me, if a doc is not readily available, I'd give D50W to a severely hypoglycemic patient after drawing blood for lab to back me up, Narcan for one of our regular Heroin OD'ers. There are other examples, but my thought process is always the patient's need vs the chance I could spend the rest of my life shlepping burgers.
Another homework question?
As the others have said, the answer is no, unless there is a protocol/standing order to follow. That includes O2 (although, as others have said, you would respond to the situation by applying the O2, then get the order). Even if a patient says, "well, at home I take Xmed for my Xsymptom and I can get it otc..."
i know there are nurses that have given cough drops to pt's when they requested it, and the nurse had them. oxygen is given if pt needs it or in emergency situations, then the physician will be called post intervention for further orders. i haven't seen any other meds given without orders.
newbiekenobe
12 Posts
like for example, cough syrup or other nonprescription drugs, thnx