med error

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I feel that I am a rather smart RN on most days, I have been a nurse for 7 years now. I now work on the L&D floor in my hospital. Last night I gave a dose of Demerol 100mg IVP to a postpartum patient that was have pain control issues following her c-section. I really did not think twice about it, as we give a lot of IVP doses on our floor. Also, the doc gave me a verbal order for this in which I thought he said IV. One of my fellow nurses informed me after I had already given the drug that it was usually given IM. I notified the MD right away, and placed bp and pulse ox monitoring on her, which by the way, all her vitals were stable, and she was doing well, just zonked. I wrote myself up and followed our protocols for med errors. After my shift I felt like such a dumbo, I mean I can't believe that I did something so stupid. The doc was not mad and the outcome was good, but do you think I could get in trouble at work for this one?

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You may get counselled but it shouldn't be more than that. Mistakes happen, welcome to the club.

Nobody should be getting IM meds for pain after surgeries, it should be either PCA, epidural, or PO.

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Specializes in Med-Surg.

Incident reports and med events should be used as learning process, to find where the error occured and find ways to prevent it from happening again.

That being said, you shouldn't be "in trouble", but I don't know how your admin. work. Good luck, and don't forget stuff like that happens to us all.

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Specializes in Med-Surg, Wound Care.

Wow, I didn't think anyone was using Demerol anymore!

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It happens....we are only human!! don't worry, the patient was fine and you'll always remember this...We do still use Demerol some but it was removed from the pca machines...we use morphine , dilaudid and fentanyl in our PCA's.

:nurse:

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Specializes in Med-Surg.
Wow, I didn't think anyone was using Demerol anymore!

Our docs love demerol 25-50/Phenergan 12.5 IV. It's there fav cocktail down in these parts.

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Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.

Its good that you caught the error quickly and that the patient remained unharmed. I'm glad you took care of her post-op pain! I bet she slept good that night!

Everyone makes med errors--its what makes us human and fallible.

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Specializes in Med/Surg; Psych; Tele.
Wow, I didn't think anyone was using Demerol anymore!

Exactly!

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Specializes in Geriatrics/Family Practice.

Intravenous Use. If necessary, meperidine may be given intravenously, but the injection should be given very slowly, preferably in the form of a diluted solution. Rapid intravenous injection of narcotic analgesics, including meperidine, increases the incidence of adverse reactions; severe respiratory depression, apnea, hypotension, peripheral circulatory collapse, and cardiac arrest have occurred. Meperidine should not be administered intravenously unless a narcotic antagonist and the facilities for assisted or controlled respiration are immediately available. When meperidine is given parenterally, especially intravenously, the patient should be lying down.

I was just looking this information up because I remember when I worked in the hospital pharmacy we had Demerol PCA's. They were a 1:1 concentration. I can't remember if they were mixed with NS or .45 NS. So I'm just curious how fast did you run it in and how much did you dilute the Demerol 100mg with. I know it was a med error but I'm just comparing what you did to a Demerol PCA rate and dilution. Sorry, just kind of curious. I'm a LPN who worked as a pharmacy tech. for 14 years prior and it's interesting how the dosing of medications can change so much going from po, to iv, im, and so on.

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Specializes in Cardiac, ER.

I'm not sure I understand the error? Did the Dr intend the Demerol to be given IM? Demerol can be given IV,.admittedly that is a pretty big dose for IV but not unheard of. We don't use Demerol much anymore unless the pt is allergic to everything else,.and we aren't allowed to push phenergan at all!

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Specializes in Rural Health.

Demerol IM and IVP is still used in my neck of the woods often actually.

100mg is a large dose for IVP but we use 25, 50 and as much as 75 mg on occassion.

Demerol is not my favorite drug because I hate the rebound it gives the patient but we have some ER docs that swear by the drug and will give it with nothing else works.

The patient didn't suffer, the doc is OK with it. You learned your lession. I'm sure all will be fine!!!

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Specializes in Med/surg/tele/OR.

Demerol 150mg IVP Q 2 hours ATC for sickle cell crisis patient. Scares me every time. Frequent flier patient he always gets this amount.

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