ED protocols that include zofran?

bill4745, RN · Mar 21, 2008

We don't. Partly because it is apparently quite expensive. The only standing orders in our ER are for tylenol or motrin.

jmgrn65, RN · Mar 21, 2008

We don't. Partly because it is apparently quite expensive. The only standing orders in our ER are for tylenol or motrin.

Zofran prices have come down, because it was a drug we could only give once and then go to phenegran.

KckStrt · Mar 21, 2008

We do give it prior to MD visit. Especially if they are waiting longer after triage, we don't need them vomiting all over the lobby and spreading whatever nasty they have, plus it helps with our over all scores when they get their survey .

rjflyn, ASN, RN · Mar 21, 2008

No we dont have anything to give as far as that goes. On that note there are times I dont feel to sorry for them as more often than not you tell them to not eat or drink anything else. What happens when you reassess them later their sitting there still vomiting but they have a bag of chips, a soda or McDonalds; well of course your going to still be vomiting dummy.

Rj

rjflyn, ASN, RN · Mar 21, 2008

Zofran prices have come down, because it was a drug we could only give once and then go to phenegran.

Not that much when we get calls from pharmacy's almost daily that a pt cannot afford the RX for 8 tabs at $125+.

Rj

kmoonshine, RN · Mar 21, 2008

Depending on how your facility charges, ondansetron ODT (generic) breaks down to roughly $20 $25 bucks a pill. I'm sure that is cheaper than the charge for placing an IV and getting reglan or phenergan, since some facilities charge for not just the IV med, but charge for the nurse pushing the med. Just thought it would speed things up - having the patient feeling better before they are even seen and sent home with a script for reglan (or zofran if their insurance covers it), rather than waiting for fluids to go in, dealing with reglan reactions, etc. Plus, not needing an IV means no infection at the IV catheter site.

We've had a really nasty bug plaguing all area hospitals, and even staff are getting ill. I was persistently vomiting at home, so I called my doc and she phoned in zofran for me. Snce its generic, I paid $10 for 12 pills (wow, would've cost $200). My hubby went to pick it up at the pharmacy, and let me tell you - waiting that 30 minutes for him to come home was absolute hell. So I sympahize with patients who are waiting for quite some time to be seen. And let me tell you, zofran works BEAUTIFULLY, and it totally kicked my nausea/vomiting. They should put this stuff in the water! :yeah:

kmoonshine, RN · Mar 21, 2008

Oh yeah, one dose of zofran 4mg ODT is safe for men, women, patients with liver disease, and patients with renal failure. Same dose for all, no adjusting needed (peds dosing is different obviously).

Larry77, RN · Mar 21, 2008

I have gone into the back for a verbal order for it before but we do not have a standing order...would be nice though.

rgroyer1RNBSN, BSN, RN · Mar 21, 2008

We dont either, the only thing we have an order for is Phenergan or Compazine-PR or IM.

Altra, BSN, RN · Mar 21, 2008

We don't have a protocol, but as soon as we get the patient in the back & get a line started, we'll often give Zofran IV prior to the patient seeing the doc.

It's been the same here - hundreds of young healthy adults coming to the ER for vomiting x 1-2 days. People have absolutely no tolerance for short-term illness. :banghead:

Blee O'Myacin, BSN, RN · Mar 21, 2008

The only potential problem I see with this idea is that the patient's symptoms will be resolved with the ODT zofran and then they will leave without being seen by a doc or PA. It only takes one person to do this, go home and die of sepsis from a burst appendix before the media and lawyers start accusing triage nurses of practicing medicine without a license. :uhoh3: (Even if the person left on their own - it doesn't matter).

Blee