IV Magnesium Sulfate in office???

monkeybug · Mar 21, 2013

As we become more accountable this will be come more common practice. an ER is not an appropriate place for migraine. its not cost efficient , much better to manage that in an office setting.

I agree with you up to a point. Status migrainous is dangerous and needs to be treated. And there is such a thing as migrainous stroke from untreated or mistreated migraines. My neuro is in another state, and we have been unable to find anyone willing to do infusions on me here in collaboration with him. Not home health, the local pain clinic, or the nearest infusion center. Some times I have to go to the ER, and I hate it. If I'm there, it's because I've absolutely gotten desperate.

SaoirseRN · Mar 21, 2013

According to the IV drug monographs I use for work, it's acceptable to administer mag sulfate without any monitoring as long as the rate does not exceed 2g/hr and it is not an OBS case. Your 1g over 30 minutes falls into that acceptable range. I would still see what the drug information says in your area, however.

jmll1765, ASN, RN · Mar 22, 2013

Primary care providers in my area send patients to the ER all the time for a dose of mag or potassium. The ER sends them to med-surg and we administer the mag or whatever and then send them home. They are usually on the floor for a couple of hours. It seems awfully expensive for something that could be addressed in the office. We've had the same patient come in 2 weeks in a row for a mag infusion. I don't mind either way, they are usually the easiest patients to care for...but from a cost point of view, I would think the office would be cheaper.

cfausek · Dec 20, 2016

I work in a primary care clinic as a triage RN and recently started receiving IV magnesium infusions for migraines unresponsive to my oral medication orificenal. I receive 1 gm over 30 minutes at an infusion center (within a hospital) and it really makes a huge difference. The only monitoring they do is basic VS before starting the infusion and they use a pump. I had no side effects and was able to drive myself home.

We don't give IV magnesium at my clinic primarily because we don't have an IV pump, although after seeing first hand how simple it is I would love it if we could do that for our patients. And yes, I do take oral magnesium - actually a fairly good dose spread out during the day - 240mg TID. Maybe it is just not enough or poorly absorbed?? Who knows