Crushing Ecotrin for G Tube, Isn't that wrong?

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I'm a new grad who just starting working at a LTC home and first let me say, I love my job so far. There is alot that I was taught in school that isn't done at the facility and it bothers me to not know what is right by the text books or what is right in the real world.

One thing, is the standard practice there is when the order calls for aspirin, then Ecotrin is crushed and used whether it's a G-Tube or crushed swallow.

I thought Ecotrin shouldn't be crushed but can anyone tell me if this sounds "normal"? They have been doing this for a long time, because I noticed it when I was there on a clinical rotation.

Thanks!

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Specializes in med surg.

The DR. should know this person is on ecotrin? However, that doesn't always happen. And yes we crush things that are suppose to be crushed. Prilosec (I think, I having a brain frat). It is tan and oval. Right on the med it says do not crush. When about 90% of residents I get are crushed in pudding. So it just one of those things. You could write a note on the asking for reg. aspirin. OR ask the charge about it. Take care Shannon

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OK, thank you, i wasnt sure how important or detrimental it could be. And they've been doing it forever that way, I'm sure it's just the accepted practice.

Me and my silly conscience, always making sure I'm doing the right thing. :rolleyes:

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Ecotrin has a special coating on it so that it will not dissolve until it gets into the intestines. This helps protect the stomach from ASA related ulcers. You should contact the doctor and ask to change it to regular ASA so as not to go against the recommendations that Ecotrin not be crushed.

If it says DO NOT CRUSH - you should not be crushing it. Does not matter what med it is. You should contact the doctor and request that the med be changed to a different form or to a different med altogether.

If you crush a med that has been noted by the manufacturer not to crush - you open yourself up for a lot of liability should ANYTHING happen.

In a lawsuit, even if the crushed med has nothing to do with the incident, an attorney will look at the fact that the staff did not follow protocols and will have an easier time documenting a pattern of unsafe care that was given - meaning you and your employer could be in deep doo-doo.

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The DR. should know this person is on ecotrin? However, that doesn't always happen. And yes we crush things that are suppose to be crushed. Prilosec (I think, I having a brain frat). It is tan and oval. Right on the med it says do not crush. When about 90% of residents I get are crushed in pudding. So it just one of those things. You could write a note on the asking for reg. aspirin. OR ask the charge about it. Take care Shannon

protonix is what you are referring to....should get the doc to order a med that can be crushed...or the ones that are beads in capsules...do not crush the beads,either

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Specializes in Acute Care.
The DR. should know this person is on ecotrin? However, that doesn't always happen. And yes we crush things that are suppose to be crushed. Prilosec (I think, I having a brain frat). It is tan and oval. Right on the med it says do not crush. When about 90% of residents I get are crushed in pudding. So it just one of those things. You could write a note on the asking for reg. aspirin. OR ask the charge about it. Take care Shannon

Sounds like you are thinking of Protonix. But, yes, we crush it too at my hospital.

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Ecotrin has a special coating on it so that it will not dissolve until it gets into the intestines. This helps protect the stomach from ASA related ulcers. You should contact the doctor and ask to change it to regular ASA so as not to go against the recommendations that Ecotrin not be crushed.

If it says DO NOT CRUSH - you should not be crushing it. Does not matter what med it is. You should contact the doctor and request that the med be changed to a different form or to a different med altogether.

If you crush a med that has been noted by the manufacturer not to crush - you open yourself up for a lot of liability should ANYTHING happen.

In a lawsuit, even if the crushed med has nothing to do with the incident, an attorney will look at the fact that the staff did not follow protocols and will have an easier time documenting a pattern of unsafe care that was given - meaning you and your employer could be in deep doo-doo.

thank you, thank you and thank you!!

dang, it drives me nuts when i hear about nurses crushing meds that are supposed to be administered whole.

it really isn't using sound judgment when administering this way.

it's important to understand why these meds aren't to be crushed.

these are blatant med errors.

the med needs to be held until the doc orders an appropriate alternative.

you may as well learn it the right way, yes?

so yes, it is wrong.

good job.:up:

leslie

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Thanks to everyone who replied. Unfortunatly, this has been going on here for months, probably years. I did a rotation at this facility and noticed it way back then.

No one is concerned and I'm assuming the doctor knows what he is doing since the Ecotrin is 325mg and his orders call for 325mg of aspirin.

Again, EVERYONE gets this from stock. Everyone who is prescibed the 325mg of aspirin.

As I've learned lately, being new to nursing, this is only one of many things that I have seen that isn't what I was taught.

The liability of it does concern me. As someone mentioned, I don't want to be looked at in a lawsuit and asked why I crushed something that goes again the manufactuers label.

I'm not being petty, but being new to all of this, I'm trying to figure things out.

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Thanks to everyone who replied. Unfortunatly, this has been going on here for months, probably years. I did a rotation at this facility and noticed it way back then.

No one is concerned and I'm assuming the doctor knows what he is doing since the Ecotrin is 325mg and his orders call for 325mg of aspirin.

Again, EVERYONE gets this from stock. Everyone who is prescibed the 325mg of aspirin.

As I've learned lately, being new to nursing, this is only one of many things that I have seen that isn't what I was taught.

The liability of it does concern me. As someone mentioned, I don't want to be looked at in a lawsuit and asked why I crushed something that goes again the manufactuers label.

I'm not being petty, but being new to all of this, I'm trying to figure things out.

don ass-u-me anything,lol.....but i think the safest way to approach this is thru the pharmacy.....i would wonder if they could save money with plain ASA?

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Specializes in Homecare Peds, ICU, Trauma, CVICU.
No one is concerned and I'm assuming the doctor knows what he is doing since the Ecotrin is 325mg and his orders call for 325mg of aspirin.

I just wanted to add my two cents. It is highly unlikely that the doc is aware this is happening. He has written an order for aspirin. Other than that, he is not involved in med administration at all. I'm sure he wouldn't even be aware which residents required having their meds crushed (unless ordered route is GT). This is where us nurses come in. It is our job to notify the physician if a certain med is ordered that cannot be crushed and we can't give it otherwise. You obtain an order for a more appropriate med.

Ecotrin is small, I've had some residents who required having their meds crushed, but was cleared by ST to give only the non-crushable pills whole if it was deemed safe. But this wouldn't work if you had to give it via GT obviously.

I would not crush it under any circumstance. I would initial the med not given, state the reason why, and document physician notified (after calling/faxing the doc). If this practice results in a GI bleed, you will be liable. Saying that they have always done it this way and they told me to do it, too, is not a permissable excuse in the eyes of the law. You are not being petty, they are being lazy. I understand you are new and may be uncomfortable "rocking the boat", but you worked hard for your license, and if you can't get this issue resolved, there are other facilities out there. They aren't all this careless.

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Specializes in Critical Care.

You might confirm exactly what kind of feeding tube it is and where in the GI tract it is....as someone mentioned in an earlier post, Ecotrin is coated so that it doesn't dissolve until it gets to the intestine. If the distal end of the tube is in the jejunum, as many are, it really wouldn't matter. Just my :twocents:

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the "official" DO NOT CRUSH list

http://www.ismp.org/Tools/DoNotCrush.pdf

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