As a new RN to the Emergency Room you are probably wondering about frequently administered medication in the Emergency Room. In this article not only will you learn about the go to ER medications, but you will also learn about some medication administration safety tips to help you succeed in the chaotic environment.
Members are discussing various medications commonly used in emergency and critical care settings, sharing their experiences and opinions on the effectiveness and usage of these drugs. Some members are suggesting alternative teaching methods for learning about medications, such as focusing on individual drugs in detail rather than presenting a long list at once. There is also a discussion about the use of generic versus brand names for medications and the importance of continuous learning in the healthcare field.
Are you a brand new nurse that just obtained the first job in the Emergency Room? Or an experienced nurse that has decided to master a new specialty? Well, whichever boat you might be in, here is a head start for you. Below is a list of medications that I promise you will be using time and time again while working in the Emergency Room. This looks like it might be an extensive list, but as time goes on, you will know the entire list inside and out.
Some of the medications are listed as the brand name and some of the medications are listed as the generic name. It is imperative that you are comfortable with both. Yes, I did do this on purpose, to not include both within this article. I am a teacher at heart, and I could not write this article without some homework involved!
Also, know what your hospital's policy is for the administration of all of the medications listed above. What might be normal practice at one facility, could get you a write up at another. Along with that, as always, never forget the medication administrations safety rules we all were taught in nursing school.
Oh yeah, and how could I forget the life-saving enemas! Saline and Mineral Oil.
Lastly, I will leave you with another tip for all new Emergency Room Nurses. Go through all of the body systems and learn what the emergencies are for those systems. Master those and you will feel comfort in knowing that when you are drowning, you have ruled out all of the time-sensitive emergencies for your patients. Once this has occurred, go down that list again and prioritize your patients from there. The Emergency Room is a no joke place to work, very fast paced and stressful. Mastering this list will help take away some of the stress and improve your overall flow. Give the department some time though, when it gets difficult don't quit. It can be very overwhelming at first, but I promise it will get better.
Extra Medication Safety Tip
Set your medication pumps up for success, not failure. When programming your pump to administer a high alert medication, set the rate to match the volume to be infused. This will prevent the entire bag/bottle of medication being accidentally administered to the patient due to your programming error. If this safety measure is not in place, it could lead to a catastrophic and life-threatening event for your patient. Imagine if an entire bag of Cardizem was administered, or the whole bag of Insulin or the whole bottle of Nitroglycerin?! Yikes! It only takes an extra second and when the hour is up: go back to set the pump again, reassess your patient, ensure that they are improving and not getting any worse, and continue on with the rest of your patients that need your services.
Just curious, are you an ER nurse? If so, how long have you been working in the ER? How many visits does it process in a year?
One statement in your post concerns me; "only a very cursory knowledge is necessary" I'm not sure what you mean by that. I hope any nurse giving me any medications has more than just a cursory bit of knowledge regarding the substance they are administering
One of the best pieces of advice I've ever gotten from any nurse came from an ER nurse with over 22 years of experience. She told me "don't ever give a medication without first knowing what it is, what action it has, how to administer it safely, what side (serious) side effects it can have, and what outcome we are looking for." Is this what you mean by cursory knowledge?
I started working in a very busy ER after graduating from nursing school and worked there for just over two years before transferring to an intermediate cardiac unit. Our ER processes over 80,000 visits/year. Our specialty is heart and vascular-another facility in the city specializes in trauma, so we rarely get those types of patients.
Out of the list of 50 drugs Mr. Heuninckx listed, I have never given:
#3 Alteplase (but it is given in our ER),
#14 Cefepime,
#15 Ciprodex,
#24 Esmolol
#35 Ketamine (given during moderate sedates in our ER),
#41 Mannitol,
#55 Rocuronium and,
#56 Romazicon (given in our ER-I've never had to administer).
Other than those I've listed, we not only administer the other drugs, we give most of them very frequently. I wish I had this list when I started my career in the ER, it would have helped give me direction. Just a thought, one medication I'm surprised isn't on the list is Adenosine. We give that quite frequently (most heart/vascular patients come to us).
Thanks, Mr. Heuninckx for taking the time and effort to compile this list.
Good list, thanks for taking the time to write this.
I'd have to add vasopressin as it's probably in the top 25 of medications that I give in the ED, although I do tend to be the one to get sepsis patients since I also work in the ICU.
As for the kayexalate, are there still facilities that are using this?
Just a thought, one medication I'm surprised isn't on the list is Adenosine. We give that quite frequently (most heart/vascular patients come to us).
Thanks, Mr. Heuninckx for taking the time and effort to compile this list.
I knew that after the list was posted that there would be, I was guessing about, 3 medication that I would later kick myself for not including in the list. Thank you for brining up Adenosine! It is given all the time and defiantly should be on the list without question.
Good looking out and this is why these forums are such a valuable part of the allnurses.com community. Thank you again!
We use still use Kayexalate in our facility as part of the hyperkalemia treatment. It's given along with Calcium gluconate, IV Insulin and an amp of D50. Some of the providers also order an amp of sodium bicarb along with the cocktail-depending on the labs. Has your facility stopped using Kayexalate? What is the typical treatment for hyperkalemia at your facility?
I love that we can bounce ideas and comments around here in this space and learn. I love to learn and appreciate sharing what I know and gaining knowledge from others as well.
I've always been surprised at how US nurses usually refer to drugs by their brand names. I'm often stumped by meds they're talking about until I google them and find out the generic name. I'd bet you'd know almost all those drugs if the generic name was used!
Here in Australia we almost always use generic names to avoid confusion. Some common drugs have 3+ different brand names!
In nursing school, we were taught to use the generic names.
We just get lazy . . . . I say Ativan to my colleagues but Lorazepam to the hospice patients because that's the name on the bottle. And I chart "Lorazepam".
And I chart "Lorazepam".
EmergencyNurse2012
33 Posts
Zmansc,
Just curious, are you an ER nurse? If so, how long have you been working in the ER? How many visits does it process in a year?
One statement in your post concerns me; "only a very cursory knowledge is necessary" I'm not sure what you mean by that. I hope any nurse giving me any medications has more than just a cursory bit of knowledge regarding the substance they are administering
One of the best pieces of advice I've ever gotten from any nurse came from an ER nurse with over 22 years of experience. She told me "don't ever give a medication without first knowing what it is, what action it has, how to administer it safely, what side (serious) side effects it can have, and what outcome we are looking for." Is this what you mean by cursory knowledge?
I started working in a very busy ER after graduating from nursing school and worked there for just over two years before transferring to an intermediate cardiac unit. Our ER processes over 80,000 visits/year. Our specialty is heart and vascular-another facility in the city specializes in trauma, so we rarely get those types of patients.
Out of the list of 50 drugs Mr. Heuninckx listed, I have never given:
#3 Alteplase (but it is given in our ER),
#14 Cefepime,
#15 Ciprodex,
#24 Esmolol
#35 Ketamine (given during moderate sedates in our ER),
#41 Mannitol,
#55 Rocuronium and,
#56 Romazicon (given in our ER-I've never had to administer).
Other than those I've listed, we not only administer the other drugs, we give most of them very frequently. I wish I had this list when I started my career in the ER, it would have helped give me direction. Just a thought, one medication I'm surprised isn't on the list is Adenosine. We give that quite frequently (most heart/vascular patients come to us).
Thanks, Mr. Heuninckx for taking the time and effort to compile this list.