IV Phenergan

[Spritenurse1210, BSN, RN]

I really hate this stuff. Anyone else with me?

[HouTx, BSN, MSN, EdD]

I agree - very dangerous. High probablility of severe tissue damage & even loss of limb if IV infiltrates into tissues. My organization set up very strict guidelines for IV phenergan a couple of years ago... basically prohibiting use in all but extreme circumstances. That eliminated problems for us.

Maybe you could lobby for the same sorts of changes.

[Hay, RN]

i have not seen anyone on my unit with that prescribed. we usually give zofran.

phenergan really tears up your ivs and causes those problems if it infiltrates? o.o !!!! sounds like it can do more harm than good!

[canesdukegirl, BSN, RN]

I hate it for two reasons:

1. I was hospitalized for about 3 weeks a number of years ago, and I had IV Phenergan q12. I no longer have ACs.

2. You can't reverse it. It is a scary drug.

[msjellybean]

Hate it, but sometimes it's my last line of defense when I've exhausted all my zofran and compazine. I try to only give it last ditch and only then to patients that have central lines.

[cdktRN]

I agree with everybody on this issue. One note is to watch phenergan with post-surgical patients. It can increase the anesthetic if they have not fully breathed it off and can cause them to go back into a coma state. There is nothing that can take it away so give it sparingly to any patient within a 12 hour post-surgical period. We give it in 3 mg increments and I try to warn our new nurses not to give a full 25 mg on post-op patients.

[DeeAngel]

Our facility has recently banned all IV use of the drug, it can be IM only.

[tokmom, BSN, RN]

Odd man out, but I love the stuff. When all else fails it works well. Granted it does have it's drawbacks. I only give in a good IV. Any thought of redness or infiltration prior, I will not push. I also super dilute it and push it verrry slowly. I rarely give 25 mg. Usually half dose.

I had phenergen after my first child was born and I was tossing my cookies. The nurse slammed in 25 mg. All I remember was seeing two husbands, and two babies. Would have been ok, but I only married one guy and had a single birth. I woke up 7 hrs later in my room with no recollection of how I got there and my mom holding my son. I wish I would have been conscious to have been there for that moment. Did I mention it hurt like heck?

You'd think I'd hate the drug, but like another poster said, it's my last defense.

[brownbook]

Do you hate to give it to patients? Or do you hate to get it when you are a patient?

As most posters pointed out many hospitals are putting strict guidelines on giving phenergan IV.

Over 5 years ago our GI doctor routinely had us give it IV. We always diluted it in 10 cc's normal saline and gave it slow. We never had a problem, but that doesn't mean it is safe. I left that facility so don't know if they are still using it?

I haven't used it since, just once in a while hear it mentioned if the patient has exhausted all other anti-emetics, but I haven't had to use it. Or it is prescribed as a suppository.

[Sun0408, ASN, RN]

I have given it a few times. I also dilute it with at least 2 10cc NS syringe. I split the dose, 1/2 in each syringe.. I still push it slow and them flush with plain NS.. I am very cautious about it.

[Argo]

FDA also issued a black label warning on it. Because of the tissue necrosis and limb loss issues.

[P_RN, ADN, RN]

I have a sclerosed vein in my right arm. Anybody want to see it. Yep Phenergan on a GI floor.