Reglan IV

Specialties Emergency

Published

Okay, I am currently in a European Country. I have heard they do things very different here. For instance, liquid aspirin, liquid valium, mainlined reglan, etc....all done with adult patients. Thoughts on these practices? I have also noted no gloves are used when starting IV's or drawing blood. I found this curious.

Specializes in ER.
Everyone loves a good dystonic reaction from time to time!

That reaction is actually akathisia.

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Specializes in ER.
Forgive my ignorance, but I think I'm not understanding what you mean by "mainlined."

An ER pt. who presents with n/v nearly always has an IV started (a lock), labs drawn, and then a bag of NSS hung to rehydrate them. Reglan, Zofran, Anzemet, Compazine or any other med can be administered IV push through this line.

If the pt. is going to have a reaction, then certainly it will have a faster onset w/an IV med than w/a med given by mouth.

You also mentioned IV Valium ... I've seen Ativan used more instead, except pre-op. Some days in the ER, I'm giving Ativan constantly ... :rolleyes: :chuckle[/quote

Apparently, in places other than the U.S., they do not automatically insert a lock. They have socialized medicine, no worries about lawsuits, and feel it isn't cost effective. I am supposing the mind-set is different here. The valium was given in a liquid form, po, which promptly came back up. The patient was a medical professional, knew what was happening, and requested a bag of IV fluids and zofran. Zofran is given here only to patients on chemo because of the cost. IV was granted only after the patient continued to request it. I have since been told be another medical professional in the area, the doctors here do NOT like being told how to care for the patients and find it rude. I have come across a few of those in the states as well.....I can say this has been an interesting experience. :)

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Specializes in Emergency & Trauma/Adult ICU.

I'm still not quite getting the "mainlined" part, and now you've piqued my curiousity ... are you saying that meds are administered parenterally without an IV catheter (I'm talking about the catheter, or angiocath - not primary or secondary tubing). I'm getting this mental picture of a syringe of a med being pushed through a needle ... kind of like a venous blood draw but in reverse.

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Okay, I'm dating myself, but in the old days (1970s in my case) we frequently "mainlined" drugs. I can remember drawing up the undiluted medication in a syringe (often fentanyl or morphine), accessing a vein, mixing the medicine with a little blood in the syringe and then slowly injecting it.

I can't believe I actually did that, and that it was the standard of practice. I would never do it today. But I guess it would be cheaper.

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Specializes in ER.
I'm still not quite getting the "mainlined" part, and now you've piqued my curiousity ... are you saying that meds are administered parenterally without an IV catheter (I'm talking about the catheter, or angiocath - not primary or secondary tubing). I'm getting this mental picture of a syringe of a med being pushed through a needle ... kind of like a venous blood draw but in reverse.

That was how we used to give Solumedrol to asthma patients who were being discharged after a bunch of ventolin.

But that was many years ago!

Chip

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Specializes in Emergency & Trauma/Adult ICU.

Rainbow & Skip ... thanks, I've learned something. Wow, being new to nursing I can't really imagine administering meds that way, but I guess it was once standard practice.

A fair number of my pts. do their own mainlining before I get to them .... :rolleyes:

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IV Reglan...oh my gosh...that stuff made me feel like I was crawling out of my skin! About 15 min after I took it I was seized by an uncontrollable compulsion to run...I felt like I was going crazy!

I can't take that stuff either - I get EPS!!! Hate that stuff...

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Specializes in Emergency.

once as a new nurse my preceptor told me to mix reglan 10mg in a 50ml bag of .9 and infuse over bout 10 minutes...............

i really didn't understand...............

now i do............

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Specializes in Cath Lab, OR, CPHN/SN, ER.

We have it in the Pyxis, don't think I've ever given it IV, only po. Have also given it for migraines. -Andrea

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Why just the other day I had a patient who was recieving Reglan IV-a continuous infusion of I believe 80 mg, in a 240 ml bag of NS, infusing 10 ml an hour. And on top of that, she was recieving 8mg Zofran every 8 hours ATC, as well as Haldol 1mg, every 8 hours ATC, AND Haldol 1mg every hour prn, for break through nausea/vomiting or anxiety, AND Phenergan 12.5 mg IV or 25 mg PO every 6 hours for nausea/vomiting.!! (cancer patient) Needless to say, she was out of it 22/24 hours a day.

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We give reglan IV often in our abdominal post op patients, either 10mg q6hr around the clock or q6hr prn. We use it for nausea and I've been told by some surgeon's that they use it because it promotes gastric emptying.

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over the years i've seen some really bad reactions to reglan, espically when pushed too fast. Saw a woman stand up on her stretcher screaming at her husband wanting to know who that strange man was! It was standard practice in my er to mix the reglan with 50cc ns and hang over 10 minutes or longer, afterall, who has time to stand at a pt's bedside and give a push over 10 minutes. Now because of JHACO, we are not allowed to inject anything in to a bag and give the drug slowly. I am able to push the med, but not put in in a bag....what kind of sense does that make? But that is another rant.

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