PCA Pump Settings

[Scoobiedoo]

I am an LPN and soon to be (30 days) an RN graduate! YEAH!

However, in my facility on the Med-Surg floor Rn's start the PCA pumps when the surgical patient arrives from PACU.

I see things like 10-10-80 or something for PCA pump orders. Can anyone EXPLAIN to me just WHAT this means?

I don't get it...

Thanks,

[chenoaspirit, ASN, RN]

at our facility...5-10-80 is 5 mg with each push of the button, dose can be delivered every 10 minutes with a 4 hour maximum of 80 mg. You need to look at the order, it may be different where you work.

[gnom]

We use continuous frequently along with on demand. My best advice would be to never initiate or change a PCA setting without the presence of another RN. I've been a nurse 31 years and I still never go it alone. I can't tell you how many PCA's have come to the floor set incorrectly by surgery. I can recall 2 incidences where Narcan was used. Scary stuff. Our pumps are set with a 1 hour limit rather than a 4 hour limit.

Well we don't know what are you guys using for ur PCA plus

you need a little shorter periods with total knees.

From my experience we (surgery) called from the floor every

single time to help out floor nurses when they screwed with our pumps.

[jrgrad1912]

We use Dose/lockout(in Minutes) / 4 hour limit. I agree to alway have it checked by an RN. I work in a 5 Bed PACU and at night I have had the surgeon check it once. My circulator had gone to do the next case and he wanted it up and running. He was cool with it and understood it was our policy. I will not start a PCA without it being checked.

[primitive]

Always Be Safe!!!! Two Nurses Should Check Pca Pump Settings Before Pt Is Given The Ok To Use Always-always-always!!!!!

[Munch]

I am going to say what almost everyone else has said because it IS so important, there should be AT LEAST 2 nurses when changing the settings or bag on the PCA pump.

I have to say one time when I was hospitalized for a week due to complications from a nasty neurosurgery they gave me a PCA. They gave me no basal rate with .6 of dilaudid push every 8 minutes. Then every 2 hours they came and hung at diluted bag of 2mgs of dilaudid PRN(I am a chronic pain patient and at first the settings were 4. push and 2mgs hung every 3 hours PRN, but at those settings I kept getting tachycardia from being in pain, getting EKG's every time you get your vitals taken gets old after a while...smile). But has anyone ever heard of giving a breakthrough dose? why not make a basal dose and then the self administered dose? That's the way my hospital does it and that's the way another hospital I had surgery at did it in the past. I guess every hospital has it's policy. Then again at that point the pain management team was in charge of my pain medication, the first time the surgical team was.