iv dilaudid

  1. I work in a community hospital where it seems like every patient has an order for iv dilaudid for pain. I am an iv therapy nurse and it seems like I get alot of calls needing me right away to start an iv because the patient needs their iv dilaudid right away. It just seems like this is the drug of choice now for any type of pain. It just seems to be given out like candy. Is is like this in other institutions?
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    About cupcake25

    Joined: May '08; Posts: 44; Likes: 69


  3. by   -MNC_RN-
    Dilaudid is getting to be more popular because of its potency and action. Half-life for hydromorphone is only about 2.5 hours when compared to morphine's 3 to 5, so it is frequently used in critical care because it is harder to "snow" a patient allowing for easier assessment.

    I haven't noticed it being used for "any type of pain", but instead of morphine in instances where IV opiates would be appropriate.
  4. by   racing-mom4
    We use it alot in the ICU. I dont think they are using it out on the Med Surg floor though.
  5. by   Gr8Dane
    Every single pt on the Med Surg floor I work on has dilaudid ordered.

    Come in with Abd pain? 1-2 MG IV Dilaudid Q3hr

    Come in Migraines/abd Pain? 2-4 MG IV Dilaudid Q2-3hr
  6. by   Tweety
    My trauma patients love it. It seems to be quick and effective. I love it for the same reason and I am seeing it used more and more. Certain patients are hard to wean from it to p.o. pills because they love it so.
  7. by   Jessy_RN
    Quote from Gr8Dane
    Every single pt on the Med Surg floor I work on has dilaudid ordered.

    Come in with Abd pain? 1-2 MG IV Dilaudid Q3hr

    Come in Migraines/abd Pain? 2-4 MG IV Dilaudid Q2-3hr
    Same on my floor. Very common drug. I always see it ordered with 12.5 to 25 of phenergan too; with specific orders to give dilaudid with the phenergan. Frankly, I'm not too happy with this practice. I've seen it catch up with some pts and the nurse running for the narcan. Just my 2 cents.
  8. by   RN1989
    Do you not have policies set up so that the staff can start their own IV's if you are not available? I've only worked in one facility that thought that an IV team was worth the money but we did have the equipment available and I would start an IV if the pt was in pain.

    With pain control being a hot topic these days, and IV meds being more the norm, you facility needs to look into it's policies on starting IVs so that you aren't being run ragged but the patients don't have to wait so long for meds.
  9. by   shelly304
    I am sitting in a hospital room because dh had surgery today. They gave him Dilaudid. Large teaching hosp. He had surg for Tethered Cord Syndrome. When the headache set in they gave him Percocet.
    Oh yeah, he is going to sleep til sun.:zzzzz
    Nurse just asked if I was looking at the news....nope, All Nurses!
  10. by   Gr8Dane
    Not sure if this is everywhere but we can not do Phenegran IV anymore, it can only be given IM and PO.

    We do Zofran w/ Dilaudid if ordered, but I have found most patients do not c/o nausea w/ dilaudid. Demerol and Phenegran IM is what I generally see ordered if I even have Phenegan ordered. Zofran is our new med of choice for n/v.
  11. by   cupcake25
    That is the sad thing about my hospital. There are no policies regarding nurses to start their own iv's. Even in an emergency situation the iv team is required to start the iv's. Some days we are in the ER 8-10 times starting their iv's they can't get and sometimes don't even try. Yes, we are run ragged and nurses get nasty when we can't be there fast enough when a patient needs iv pain medication.
  12. by   P_RN
    SS Crisis is about the only time I've given dilaudid, and then usually through a central line like a medport. Is this changing everywhere? And I certainly wouldn't want to be the patient who had to wait for someone to have the time to start a line. Is there a reason floor nurses don't do iv therapy where you are?
  13. by   gonzo1
    lot's of dilauded being given out at our place too.
  14. by   Woodenpug
    Yes, we use diluadid IV for most patients. On nights, we start IV's. Still, it seems simple enough, if po isn't contraindicated to get an order for a one time po pain med. I would think at an institution where IV team is mandatory, the slower onset for po meds would compensate for the time it takes to get an IV team member to start an IV. Then, after the IV is started, a break through dose of 1mg morphine IV to get them through the four hours duration of the po med. That's a rough example and would be the MD's choice, since I don't prescribe medications. Another alternative would be a one time IM. Lack of imagination is no excuse to abuse co-workers.