Fentanyl/Versed on locked pumps ?

Specialties MICU

Published

Our SICU runs Fentanyl and Morphine infusions on an AIMS PCA pump. It's locked for security and we document wastage just as we do other controlled drugs. My question is does your facility practice this also? What about Versed drips? Who mandates this? We need to develop a policy and need to benchmark with other facilities. I welcome your input.

Specializes in ICU.

we run our fent, versed, nimbex, ativan, on regular iv pumps, and we usually run them all together o the same pump/line. MS, dilauded, demerol are all run through pca. We do, rarely, have fentnyl on pca, but only if someone has issues with everything else. usually if we start it , its just on a regular pump. We also don't document waste on things run on the regular pump. However, these all have to be taken from pyxis, and signed out by 2 nurses.

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Specializes in Palliative Care, NICU/NNP.
In Texas, at least, one of the decision models for practice is - does the literature support the decision? It certainly doesn't contradict the position that narcs should be locked through delivery. But, in regards to IV gtt admin, I can find no literature that mandates such practice.

Timothy.

Timothy

Timothy,

I do have to agree with your original statement about these drugs being locked up. I think because the ICUs I've seen have good visibility and have low RN:pt ratios that anything untoward would probably be seen. And in a crisis it would be time consuming to have to unlock the lock.

But, since I on work on a small palliative care unit with sliding glass doors to the outside, I definitely think these things should be locked up.

This isn't an advertisement for Alaris pumps but they do have a nice locking system and not just the button in the back you push.

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Specializes in ICU.

Morphine, versed, and fentanyl can all be run on a regular pump in our facility, we just have to document new hangs, end of infusion, and end of shift counts. The only things we lock up are true patient use PCAs.

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What kind of locked pumps allow for fentanyl and benzos? I've only seen MS, dilaudid and demerol run at a basal rate on those PCA pumps--I didn't think they made compatible containers for benzos and fentanyl....

Our regular infusion pumps have a locking mechanism, but that wouldn't stop someone from tapping the infusion bag...

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Specializes in Critical Care.
What kind of locked pumps allow for fentanyl and benzos? I've only seen MS, dilaudid and demerol run at a basal rate on those PCA pumps--I didn't think they made compatible containers for benzos and fentanyl....

Our regular infusion pumps have a locking mechanism, but that wouldn't stop someone from tapping the infusion bag...

Most PCA pumps use standard 60ml syringes. Your pharmacy can make fentanyl and ativan syringes to run on a PCA at basal rate. That's what we do. And both the rate and containers are locked out and safe during delivery.

~faith,

Timothy.

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Specializes in ICU, psych, corrections.

Our PCA pumps use a 30ml syringe. We run all narcotics through a PCA. I've been in my ICU since 2003 and have NEVER seen a narcotic gtt unless it's locked inside a PCA going at a basal rate or if it's for an epidural (for some reason, epidurals are run on non-locked pumps with just the bag of narc hanging....usually fentanyl or dilaudid). We run versed, ativan gtts on a regular pumps.

The PCA syringes must be cosigned by another nurse when changed or if a PCA is initiated. I can't fathom having morphine, fentanyl, dilaudid, etc. on an open pump, except for our epidurals. But even that is changing and they are going to this tiny little yellow box that is strictly for epidurals. It's a system that requires a key code to unlock on the keypad and then the entire set up is put into a clear plexiglass box that attaches to our IV poles. You cannot get into it without the key, which is the same key used for our PCA's.

Melanie = )

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