pain meds

a bit confused

say i have percocet q4 i give it it last four hours. but before percocet is up patient ask for iv dilaudid. i always thought you waited until one pain med was finish before you gave another. but patient and other nurses are telling to give the dilaudid even thou the percocet is still q4. how does pain meds schedule work? do i wait for it to finish then give dilaudid

I'm not sure what you mean "waiting until percoset is finished" before you give Dilaudid. Do you mean you want to wait four hours after giving Percoset before giving the next dose (or first dose) of Dilaudid? If that's the case, the other nurses are correct: those two drugs work differently, and you are absolutely able to overlap them. I personally wouldn't give Percoset and at the SAME time I give a dose of Dilaudid, but there's nothing wrong with giving that percoset, waiting a bit (we usually give it an hour) and then giving Dilaudid. You have choices in pain meds BECAUSE a patient frequently does not get relief with just the one.

Many times I have a pt in pain that requires more than one pain med. I usually give PO meds 45 mins to 1 hour (if pt not appearing to be a true 10/10 pain pt - otherwise start with dilauded). Then assess pain - and give dilauded if pt pain goal not met. Then another 20 mins roughly and reassess - not meeting pain goal - call dr.

We have a frequent flier that is a drug addict - but has a real need for pain meds when he is at hospital - has a chronic condition that obviously requires pain meds - takes enough to get him pain managed to put me on a ventilator.

a bit confused

say i have percocet q4 i give it it last four hours. but before percocet is up patient ask for iv dilaudid. i always thought you waited until one pain med was finish before you gave another. but patient and other nurses are telling to give the dilaudid even thou the percocet is still q4. how does pain meds schedule work? do i wait for it to finish then give dilaudid

Good question, but think of it like this: If the pt is at home and is given Morphine for pain, but still experiences break through pain, the doctor will often prescribe a different pain medication to be used in addition to the Morphine. No, don't give the two at the same time, and if you are questioning if the pt is drug seeking that may bring up other issues. But if the pt is truely in pain, and the percocet is working in an hour or so, to let them continue to be in that kind of severe pain and not address it is violating their patient rights to have their pain managed. Know your drugs and how they work. But if you are not comfortable giving the full dose of Dilaudid, you can always start low and add to what you give, up to the Dr's ordered dose. Just monitor your patient and use your critical thinking skills.

If I have 2 different pain meds. IN this example dilaudid and percoset. I will give the percs first. Reassess in an hour(ideally), most of the time it is two because of other people. Then if they are still in pain, but can't get the percs than give the dilaudid. Over time the pain will decrease and the iv dilaudid will not be used as much. Just my opinon.