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67 Medications Every New ER Nurse Must Master!

Emergency Article   (220,977 Views 33 Replies 847 Words)

Michael M. Heuninckx specializes in Emergency Department.

17 Articles; 39,186 Profile Views; 43 Posts

Are you a brand new Nurse to the Emergency Room? Well you are in luck! Learn in this article about 67 medications you will be administering frequently in the Emergency Room. 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.

67 Medications Every New ER Nurse Must Master!

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, which ever 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.

In alphabetical order and not limited to. . .

  1. Albuterol
  2. All of your fluids NS 0.9, Dextrose 5% NS 0.9, Lactated Ringers. . .
  3. Alteplase
  4. Amiodarone (Push and Infusion)
  5. Aspirin
  6. Ativan
  7. Atropine
  8. Atrovent
  9. Azithromycin
  10. Bacitracin
  11. Cardiac Arrest Medications (See your ACLS Textbook)
  12. Cardizem (Push and Infusion)
  13. Catapres
  14. Cefepime
  15. Ciprodex (Otic Drops)
  16. Ciprofloxacin
  17. D50 Push
  18. Decadron
  19. Dilaudid
  20. Diphenhydramine
  21. Dobutamine
  22. Dopamine
  23. Epinephrine (Push and Infusion)
  24. Esmolol
  25. Etomidate
  26. Fentanyl
  27. Flagyl
  28. Fluorescein Strips
  29. GI cocktail: Maalox, Donnatal & Lidocaine (PO Mixture)
  30. Haldol
  31. Heparin
  32. Ibuprofen
  33. Insulin
  34. Kayexalate
  35. Ketamine
  36. Ketorolac
  37. Labetalol
  38. Levophed
  39. Lidocaine (Injection, IV Push & Infusion)
  40. Magnesium
  41. Mannitol
  42. Morphine
  43. Narcan
  44. Neosynephrine, (nasal spray & IV Infusion)
  45. Nitroglycerine (Pills, Paste & IV Infusion)
  46. Ondansetron
  47. Pepcid
  48. Phenergan
  49. Plavix
  50. Prednisone
  51. Propofol
  52. Protamine Sulfate
  53. Protonix
  54. Rocephin
  55. Rocuronium
  56. 56. Romazicon
  57. Silvadene Cream
  58. Silver Nitrate sticks
  59. Sodium Bicarbonate (Push and Infusion)
  60. Solumedrol
  61. Succinylcholine
  62. Tetracaine (Ophthalmic Drops)
  63. Tylenol
  64. Unasyn
  65. Vancomycin
  66. Verapamil
  67. Versed

Phew!

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.

Michael M. Heuninckx RN-BSN

****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.

If you like this article then you might want to check out Michael's new book for nurses...

Code Blue! Now What? Learn What To Do When Your Patients Need You The Most!

67-medications-every-new-er-nurse-must-master.pdf

17 Articles; 39,186 Profile Views; 43 Posts

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airwaynurse has 22 years experience and specializes in Critical Care, Flight Nursing.

2 Articles; 20 Posts; 5,305 Profile Views

Enjoyed this article Michael! Nuts and bolts stuff. Training and preparation is the key to any successful endeavor. I always taught new critical care nurses, flight nurses and paramedics (don't ever sell paramedics short) to further subdivide the list into the Advanced Life Support medications (especially the push meds), the medications that can quickly lead to untoward effects (such as death, etc.) by their improper usage; sodium nitroprusside/nipride or propofol immediately come to mind. All of the airway/intubation drugs should be locked in your compendium stone cold; etomidate, succinylcholine, rocuronium, etc. The difference between polarizing and non-depolarizing agents is tantamount to their application as well. In the ED it is very important to know the EMS drugs in use in your area as well....it helps connect the dots.

 

Your article also brought to mind one of my favorite sayings from over 20 years of training and instruction of clinicians at all levels: "Pathophysiology covers a multitude of sins!" Good, solid knowledge of pathophysiology is essential and intentional. You have to keep studying and learning until you nurse no more.....your patients require this type of commitment from their nurses. It is so sad to see many nurses that have no desire to dig into the great depths of pathophysiology. Alas, the gap between a JOB and a CALLING is certainly abysmal. Nurse on brother! Thanks...

 

See one, Do one, Teach one!

 

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GrumpyRN has 37 years experience as a NP and specializes in Emergency Department.

1 Follower; 654 Posts; 16,905 Profile Views

After 20+ years in an ED and 30+ years as a nurse I understand about 40% of those medications.

Different country, different names.

Very Americancentric.

Not a complete criticism, merely an observation.

Edited by traumaRUs

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ChronicSG specializes in Oncology.

63 Posts; 2,035 Profile Views

Enjoyed this article Michael! Nuts and bolts stuff. Training and preparation is the key to any successful endeavor. I always taught new critical care nurses, flight nurses and paramedics (don't ever sell paramedics short) to further subdivide the list into the Advanced Life Support medications (especially the push meds), the medications that can quickly lead to untoward effects (such as death, etc.) by their improper usage; sodium nitroprusside/nipride or propofol immediately come to mind. All of the airway/intubation drugs should be locked in your compendium stone cold; etomidate, succinylcholine, rocuronium, etc. The difference between polarizing and non-depolarizing agents is tantamount to their application as well. In the ED it is very important to know the EMS drugs in use in your area as well....it helps connect the dots.

 

Your article also brought to mind one of my favorite sayings from over 20 years of training and instruction of clinicians at all levels: "Pathophysiology covers a multitude of sins!" Good, solid knowledge of pathophysiology is essential and intentional. You have to keep studying and learning until you nurse no more.....your patients require this type of commitment from their nurses. It is so sad to see many nurses that have no desire to dig into the great depths of pathophysiology. Alas, the gap between a JOB and a CALLING is certainly abysmal. Nurse on brother! Thanks...

 

See one, Do one, Teach one!

 

I loved this, and I love pathophys! Who wouldn't want to know more about this amazing subject? It's our bread and butter and it's what allows us to better understand the treatments we are providing. I'm definitely gonna keep up with the subject once I pass the boards!

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suga_junkie has 3 years experience as a BSN, RN.

90 Posts; 4,743 Profile Views

After 20+ years in an ED and 30+ years as a nurse I understand about 40% of those medications.

Different country, different names.

Very Americancentric.

Not a complete criticism, merely an observation.

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!

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traumaRUs has 27 years experience as a MSN, APRN, CNS and specializes in Nephrology, Cardiology, ER, ICU.

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Ok guys....please realize that AN DOES originate in the U.S.

We all realize that we call meds by different names. The care can be different too.

however the common goal is the care of the patient.

Several posts in this thread have been edited Or deleted to comply with the terms of service.

We we always welcome articles from AllNurses informing our readers how care is rendered in different countries.

Edited by traumaRUs

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synaptic has 5 years experience.

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there was a podcast with like the top 200 rx drugs somewhere on itunes but I could not find it last time i was on there. It was in short 5 minute audio clips. It was great and very helpful. good article BTW.

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PG2018 specializes in Outpatient Psychiatry.

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I worked the floor right out of nurse school and it seems like all we gave were iv antibiotics and Protonix.

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zmansc is a ASN, RN and specializes in Emergency.

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I'd say a fair portion of this list either isn't used at all, or is so rarely used that only a very cursory knowledge is necessary and listing all of the medications as if they are all of equal value is somewhat misleading. I do think this list and the many other lists of meds to be aware of are all good starting points for new nurses to the ED setting however. From an educational standpoint, I think it would be easier for new ED nurses to gain a working knowledge of this list if they were presented in an easier to grasp format, for example by drug categories. Just my $.02 (adjusted for inflation of course).

I am curious to poll the ED nurses here on use of romazicon at their facility. I have never seen it used at my facility. Every provider I talk to feels the potential side effects out weigh the potential benefit. Is it used at your facility? How frequently? What is the criteria where the docs decide it is worth the potential side effects? How often does it induce seizures?

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NRSKarenRN has 40 years experience as a BSN, RN and specializes in Vents, Telemetry, Home Care, Home infusion.

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ROMAZICON (flumazenil)

is indicated for the complete or partial reversal of the sedative effects of benzodiazepines in cases where general anesthesia has been induced and/or maintained with benzodiazepines, where sedation has been produced with benzodiazepines for diagnostic and therapeutic procedures, and for the management of benzodiazepine overdose.

Romazicon (Flumazenil) Drug Information: Indications, Dosage and How Supplied - Prescribing Information at RxList

With the exception of Romazicon, these are the top meds I've seen used throughout my 35yr career,majority are seen in my home care patients discharge med list too. Great list that can help prepare US nurses working in ER's and hospitals.

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synaptic has 5 years experience.

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I've only used romazicon once. Usually if its just benzos they sleep it off pretty well without any problems. If other stuff is added it really isn't of much benefit since the other meds they usually overdose on are much more dangerous. I do use Narcan a little bit more frequently though for obvious reasons.

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Michael M. Heuninckx specializes in Emergency Department.

17 Articles; 43 Posts; 39,186 Profile Views

I am curious to poll the ED nurses here on use of romazicon at their facility. I have never seen it used at my facility. Every provider I talk to feels the potential side effects out weigh the potential benefit. Is it used at your facility? How frequently? What is the criteria where the docs decide it is worth the potential side effects? How often does it induce seizures?

In my Emergency Nursing career I have only used Romazicon once. With that being said, when ever I am orientating a new nurses to the ER, and we are discussing medications, I always focus on drug classes of medications they are administering. Along with, potential side effects and what reversal agents are available. I agree with you that Romazicon is not frequently used, due to its potential side effects, but still is important for a novice ER nurse to be aware of.

There could be a situation where a newer provider/rotating provider wants to use this medication and due to the nurses medication knowledge, offers a suggestion to reconsider the medication order due to its potential side effects, in turn, saving the patient from a potentially bad outcome. I always encourage and motivate nurses to questions/double check an odd/risky medication order, and this medication, even in my own practice, I would question. Hence the importance, I see, in being well versed in knowing this medication. Just because something is not frequently administered, there still is value in knowing about the medication.

Michael M. Heuninckx RN-BSN

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