iv dilaudid

[cupcake25]

:sniff: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?

[Woodenpug, BSN]

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.

[EricJRN, MSN, RN]

Our ER docs love it.

[emnicams]

I am seeing it more and more on my floor, but morphine is still more common. (I work on what is supposed to be a cardiac stepdown unit, but we have lately become the Nursing Home on Telemetry unit. LOL)

[MrsMommaRN]

i work on an ortho joint repalacement floor and prn in the ed. yes we give more and more dilaudid. lots of patients come in and state they are allergic to morphine so the dilaudid is given.

[Altra, BSN, RN]

Yep, lots of IV Dilaudid here, for every type of pain including migraine headaches.

I'm curious though ... about all those admitted patients in the OP's hospital who do not yet have saline locks. This would be rare where I work. Even a patient directly admitted to med-surg, not coming through the ER, will get a lock inserted sometime within their first few hours unless there's really a good reason to not have IV access.

[RN50, ASN, BSN]

I work on Med-Surg Oncology floor. We also get a lot of patients with SSC. They get Dilaudid PCA's and Phenergan IVPB. Of course, every patient that we see with SSC is allergic to Morphine, so they get their Dilaudid PCA's and then they are happy.

[lpnstudentin2010, LPN]

At the hospital I am a patient:

#1 - morphine

#2 - Dilaudid

#3- Phyntynal or Demeral

I am allergic to 1 and 2 so I have one of the ones in 3.

[Piki]

I work a post surg med-surg unit and we go through alot of Dilaudid. Morphine as well, but I'd say they're about equally ordered.

[-MNC_RN-]

Interesting. At my hospital, the only nurses who start IVs are in the ED and the IV team. Has been that way for years. We've never had a problem with IV team not being available PDQ for an IV start if needed.

[lpnstudentin2010, LPN]

Interesting. At my hospital, the only nurses who start IVs are in the ED and the IV team. Has been that way for years. We've never had a problem with IV team not being available PDQ for an IV start if needed.

My hospital, there is an IV team, but any nurse, hospital certified in starting ivs can.

[David Offenbaker, BSN, RN]

Lately I've had a lot of patients on Dilaudid IV (usually 2mg)-- then the rst of mainly morphine. I work at an LTAC and most of the dialysis patients are on Dilaudid, and of course have the lidocaine patches as well.

Also, at our facility anyone can start peripheral lines-- but many tend to have PICC lines which make lab draws a breeze! I used to be intimidated by starting IV's in nursing school, but now I tend to be the one called when a patient has "no good veins"... Odd how things turn around like that.

Dave

[Babs0512]

I work PACU, dilaudid is often ordered along with zofran (typicall).. Works faster and Morphine with short half life. Works better as it is 10 x stronger than morpine as well.