phenergan

[moni929]

What are your hospital protocols on pushing phenergan IV?

[TheCommuter, BSN, RN]

1. It is not to be pushed through a peripheral line due to the risk of extravasation. The stuff destroys veins.

2. It can be given IV push through a central line. If peripheral access is present, it must be infused via IV piggyback over 15 minutes while diluted in 50cc of normal saline.

[IVRUS, BSN, RN]

Because of the numerous lawsuits involving IV phenergan, many have dissallowed its use, unless the patient has a central line in place. As the previous post stated, this medication is nasty if it extravasates as it is a VESICANT.

[CountryMomma, ASN, RN]

Our protocol is similar to TheCommuter's. We are NEVER allowed to run fluids of any kind w/o a Plum Pump, so we mix it in a large syringe and piggyback it onto the B line. For super delicate veins we might run it concurrently with TKO.

[calivianya, BSN, RN]

We can push it - I always dilute it with a full flush, push slow over at least 2 minutes, and make sure there are maintenance fluids infusing on the line I push it through so it gets further diluted as I push it.

[Lev, MSN, RN, NP]

At my old facility I pushed it into peripheral lines on med surg. I don't know of a specific administration policy but when I read about how nasty it was I always diluted it and pushed it slowly. It has a lot of side effects too.

[SierraBravo]

Aside from extravasation, pushing phenergan can cause hypotension. No bueno. Dilute it in 25mL or 50mL of NS and hang it on a pump as a secondary over 10-15 minutes. Granted, all of my patients have central lines so I'm not concerned with extravasation.

[SilleLu]

Glad to see this question...ran into a situation as a student about giving this IVP, after checking resources and seeing the warnings, I refused to push this into hand veins. We ended up diluting and setting it up on a syringe pump over 15 min but I don't know that was much better.

I see other posters would have diluted into 50cc and hung as IVPB, if the order states IVP, can you do that as nursing judgment, or do you have to get the order changed to IVPB? I would have much rather done it IVPB I think.

[JessicaDanielle]

Currently, we typically give IVP, diluted with 10ml NS, and over 2 minutes.

[AJJKRN]

It is best practice (per my facility) to dilute 12.5 to 25 mg of phenergan in a 50 mL bag of NS and administer via piggyback over 15 minutes. Until a year ago we would just mix in a 10 cc flush and gave IVP over 5 minutes but patients were needing multiple IV sticks because their veins/IV's weren't holding up long when they were getting pheregen IV q6. Unfortunately we're still working on other problems because most of the patients who got phenergan also got IV Benadryl and dilaudid as well...another different yet related issue...imagine their dismay when we offer phenergan suppositories to them now instead

[Gooselady, BSN, RN]

Wow, we need to catch up. It's been acceptable to dilute up to 12.5mg in a 10ml flush, and give slow IVP over two minutes. I usually stuck the dilute on the B line and programmed it to go in with the compatible main line fluids over ten or fifteen minutes.

[SassyTachyRN]

Our pharmacy premade ours in 50ml bags to be hung IVPB. We infused them over 30 mins.