Discharge from ER after Medication administration

1. I know this question may seem trivial, but we are having some issues with when to discharge patients after they receive medications? What are other institutions doing regarding this?
   Thank you for your response!
2. 

   About Pameula

   Joined: Jul '98; Posts: 5
   Clinical Educator Critical Care

   19 Comments

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3. 
   Apr 21, '02

   PO meds, OTD (out the door) immediately, IM meds 20 min hold.
   IV meds..by the time you d/c the IV and give instructions, more than enough time has passed.
   
   bob
4. 
   Apr 21, '02

   Same as what bob said in my ER.
5. 
   Apr 21, '02

   In our ED we usually wait 15-20 min to check for allergic reaction...of course no one should leave after getting a narcotic without a ride home.
6. 
   Apr 22, '02

   what everybody else said!!! :d however, it also depends on whether they are driving home themselves or not, and what meds were given.
   we had an agency nurse come into work one nightshift a few months ago. she gave somebody demeral and either vistaril or phenergan. she then discharged the patient, where the patient proceeded to drive home, and wreck into a telephone pole! i always hated how those things jumped out in front of cars! :chuckle
   the bad news is, she did not document a gcs, loc, gait, msps.........nothing!!!
   so you all know where this is going....guess we'll find out in a couple years.
   
   btw...that was the first and last time for her to work in our ed.
   
   
   
   me
   
   
7. 
   Jul 12, '02

   Wow, ok..OTC meds, right away. IV meds..1/2 to see if a reaction occurs. Any narcotics..we make sure you are either driven or taking a cab home. We are pretty diligent about this...cause we don't want them back as a trauma pt.
   
   JO-ANNE
8. 
   Jul 17, '02

   Howdy Yall
   From deep in the heart of Texas
   
   Righto
9. 
   Aug 6, '02

   Same as above for us. Except if you get narcotics, I have to see the "whites of your ride's eyes" before I let you out the door. Our ED doesn't allow releasing to taxi's bc it's not realeasing to a person who is responsible for you. They pt's usually understand, and if they don't it's bc they usually are drug seeking.
10. 
    Aug 7, '02

    Hi Guys
    We also have the 20 min "shot law" we call it . Any IM narcotics,antibiotics and now even Toradol - we had a lady who had an allergic reaction to Toradol IM and almost coded . Thank goodness she had not gotten out of her room and into her car yet. We have also tried to make it a routine to not medicate people until their ride is in the ED and we have seen them walk also . We have quite a few sneaky drug seekers out there that have sneaky or imaginary drivers or those drivers that are checked in as a patient too.
    what do you guys think about patients that walk in and want to walk back home after medication , I have alot of homeless folks that wander in with various problems. Most of these guys are intoxicated at their normal blood levels, unless its say 20 degress outside I have let them walk back to the happy bridge.I am also known to have 2-3 of them at a time sleeping in the ED all night- they know to get up , get their coffee and be on the road again at 6:30 am before day shift wanders in.
    Bye now
11. 
    Aug 7, '02

    Howdy yall
    from deep in the heat of texas
    
    My all time favorite is when they check into er as couples and are in different rooms. they say yes they have a ride. They both get medicated and drive each other home. I havent been fooled on that one in years,. But new ER nurses fall for that all the time.
12. 
    Aug 20, '02

    . may be best to check with your P&P's to see if you have any set time liimits.-------------------------- seekers , frequent flyers. ect are treated the same in time limits as the average joe blow, but be sure the have a ride .------------ what i hate is doc's that say it's ok if you give em the shot and let em go ---- I know em! well the doc might know but i sure don't
13. 
    Aug 24, '02

    We get them in and out like cattle. But no narcotics if driving and 15 minutes after an IM injection. With IV's its usually enought time by the time we get back to take them down.
14. 
    Aug 24, '02

    pretty much like bob said. unfortunatley, we are a busy er and don't have the time to monitor up to four hours for adverse side effects.

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