Comfort care med protocol?? - page 2
70 year old pt CHF, ESRD on a vent with dyspnea , b/p 70/30 currently on comfort care only. Dr ordered ativan 4mg/ morphine 4 mg IVP . Due to the difficulty in breathing I gave the morphine dose... Read More
Oct 5, '07Specialty: 28 year(s) of experience in Med/surg,Tele,PACU,ER,ICU,LTAC,HH,Neuro ; Joined: Sep '07; Posts: 463; Likes: 177You could ask for an order to titrate up to 4mg of Ativan Q4 hrs. so if less does the trick you can hold there.
Oct 5, '07Joined: Apr '00; Posts: 24,611; Likes: 35,453Quote from leslymillexactly.You could ask for an order to titrate up to 4mg of Ativan Q4 hrs. so if less does the trick you can hold there.
to randomly give 4mg of ativan in a geriatric, esrd pt is dangerous.
i'm the first one to want to appease one's suffering.
but my yrs of experience strongly tells me that 4mg is pushing it way over the edge.
Oct 5, '07Joined: Oct '02; Posts: 60,607; Likes: 17,439Quote from starcandyI agree, not being the one to give the "death dose" is a tough one for many of us when dealing with the actively dying.This is what I did I gave the morphine and pt was sedated resps decreased from 30's to low 20's. It was ordered q 1 hr prn. I know the goal is to maintain comfort but I did not want to be the one to speed up her impending death. I assume terminal weaning wwill be discussed very soon.