I am missing something obvious?

[missmollie]

Is there a reason why we would give a PO medication to a patient who is vomiting? I can understand giving that prescription to someone at home with no option but PO, but in the hospital when the patient has IV access...what am I missing?

[BSNbeauty, BSN, RN]

I've given it rectally before.

[Volley88]

I'd just call the MD for clarification. And state, "Pt is vomiting, unable to hold anything down. Is IV route possible?"

[marie.rn2419, RN]

The first year resident may have ordered Phenergan PO because it is not given IV in may places anymore because its pH is so low (4, I think), and it can be a vesicant with devastating results. He may have thought PO is better than nothing! I love Phenergan but understand the concerns. Compazine is given PR too. When I would get stumped trying to help the patient and the resident, I often called a pharmacist, who was my savior more than once. That is terrific that you are in a University Hospital, where you have many resources.

As I said before, I'm stunned that Phenergan is still being used. But maybe if it's in a 50 ml bag of NS and given over 15 minutes, that is acceptable at some places. I few years I was very nauseated post-op and tried everything with no relief. I begged the Fellow for Phenergan, and he ordered a tiny dose IM, which gave me relief.

I always find it interesting reading about the norm and trends for different places. So, I'm at a L1 trauma ctr, west coast. We use Phenergan IVPB over 15 min fairly often. Zofran is the norm by IV. I've had it ordered SL once, I truly think by mistake. But I didn't need to use it so didn't page for it. I've actually only had phenergan ordered IM once, never PO. Also only given Compazine here IV. Haven't heard anything about a shortage around here, but maybe it is specific to the distributor?