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Discussion

Medication during dressing changes

  • Experts

Quick question...

You are in the middle of a dressing change and the pt reports severe pain. What do you do?

My thoughts were give them more of their IV morphine (let us say they have only had 5mg IV and can have up to 10 mg).

Surely you wouldn't want to continue the dressing change when the pt is in that much pain. Clearly you would have to ensure that the wound wasn't left gaping and uncovered.

I'd be interested in your thoughts.

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    • Featured Replies

    Well, I guess it depends what's happening.

    I'd have to consider how long it was going to take me to finish the dressing change - since I'm half-way through I'm likely to just finish... unless I'm doing deep packing which (a) can take awhile and (b) can be pretty uncomfortable (though I'd have already narced 'em up before I started).

    I'd also consider how the patient is handling their severe pain and consider whether the pain is transient or persistent.

    I might also consider whether the patient is in isolation d/t the time required to ungown and regown.

    As I said, though, I'd have certainly timed my dressing change so that the narcs were at their peak when I started digging around.

    Some pain - even a bit of severe pain - is inevitable in certain circumstances, especially if it's just a momentary thing.

    If the patient was not tolerating the pain, though, I'd likely stop the procedure and give whatever meds I had left at my disposal.

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    • Experts

    Put on my call light and ask another nurse to obtain the needed pain med.

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    • Author
    • Experts

    Thanks so much! I know a lot of this comes with experience and is dependent on so many variables.

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    • Experts

    I would also pass along a suggestion that in the future the patient receive pain meds before the procedure.Where I work that is quite often done for patients with pain issues before any procedure including personal care.

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