"IM doesn't work for me"

Specialties Emergency

Published

Had a patient last week who presented with multiple track marks and NO veins. I'm a pretty good stick, and couldn't even find a spider vein to get a 24 in. She claimed migraine, and also stated that "IM phenergan doesn't work for me." Said only thing that worked was IV Dilaudid and Phenergan. I've never run across a true instance of an IM med not working well when the IV form does...maybe takes longer, but still usually works. What is your experience?

Specializes in ED, ICU, PACU.
I starts looking at the neck and trying to find the ej then sometimes theyll give up say forget it and leave-hopefully.:bow:

Is that before or after you use the tourniquet to have the vein pop up????:hehe:

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Specializes in ER/SICU/Med-Surg/Ortho/Trauma/Flight.
Is that before or after you use the tourniquet to have the vein pop up????:hehe:

LOL!!!:lol2::lol2::smokin:Dont try this at home!!!lol!!!

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My sister is a large woman, weighs around 300lb, don't tell her I told you guys. They finally give her IM Demerol and phen. No help. Another IM dose of same, nothing. Total of 20mg morphine, no help. Still crying. Try to do the splint anyway, crazy people, lol. They heard her scream on the 5th floor.

I'm fairly large (4'11 and 180) so I can understand the issue. Like other people said, sounds like the needle didn't actually get into muscle. Fortunately I don't have much fat over my glutes as opposed to my thighs and stomach, so I haven't had that problem.

But in your case, I have to say my seeker radar would have been going off, also. My sister wouldn't know a IV street drug if it bit her. This girl sounds like she knew exactly what she was talking about as far as veins were concerned, and there is only a few classes of people that know stuff like that. Nurses, for one, lol, and IV drug users. They are the only people I've ever had make comments like the ones she made.
My father is an IV drug user, so I agree here. My dad now has a port, but in the past he's told doctors which veins still were good. He's been able to find doctors who are somewhat sympathetic to his situation (now been HIV+ for over 15 years and full blown for 10) and while they won't write him narcs or other high abuse potential drugs, they keep track of his condition closely. Dad actually hasn't done any IV drugs for several years -- he switched from IV meth to crack. *sigh* From his experiences I would agree with most of the people on here -- if you're an IV user the other methods of getting the drug just aren't what the person is looking for. Dad has said often enough that he'd never snort meth, that only the IV buzz gives him what he wants. In your sister's case it wasn't what she WANTED, it was what she needed -- the pain relief, not the buzz, and the needle just couldn't get into the muscle.

When he was in jail a few years ago, they needed to draw blood but didn't have the stuff needed to flush his port. The jail nurse tried to stick him once, then handed him the rig and had him do it himself. He got it first try, but not on the vein the nurse went to first.

I keep telling him he ought to get clean and after he'd been clean long enough that they'd hire him, become a tech and work at a blood bank doing withdraws. But he's too caught up in his addiction to even try to make something good of himself, and being HIV+ they might not want him.

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I have a question for you full nurses (I'm just a student). In your experience, are the families of junkies more or less likely to become addicts themselves?

I feel very lucky that I went to Alateen. Alateen is not just designed to help a person deal with their parents' addictions, but also to help recognize addictive thoughts and patterns of behavior in themselves. Because of those lessons, I'm considered by most of the people I grew up with to be the "furthest thing away from an addict".

I occasionally drink, but only with friends, and usually only on NYE. I may have a glass of wine if I go out to dinner, and it's a special occasion. From the first time I ever drank, I set rules for myself -- I would not ever keep alcohol in my home, I would not drink except wine or mixed drinks at a bar or restaurant, I would not drink alone, I would never drink without eating something more than an appetizer, and I would not drink if I was in a bad mood or was trying to escape a problem. I've followed those rules. If a doctor gives me medication I know can be habit-forming, I tell them about my father's addiction and request that they try to find a medicine that's not habit-forming. When they can't, I try to take the least I can, for the least time I can. I think I've done pretty well. I'm also with a person who does not drink at all except a half-glass of wine occasionally when we go out.

But in your experience, is this a common way for the family members to act, or is it more common for them to fall into the same trap?

For me, I would never want to put people who cared about me through the hell that my father's addiction did to our family. I would hope that others would have the same thoughts.

Thanks!

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Specializes in ER/SICU/Med-Surg/Ortho/Trauma/Flight.

Malanya, Im not trying to be judgemental on here, but we get so much of this you know what, it just gets old and we need some humor, I am so sorry about your father, I would not know thankfully almost everyone in my family is a nurse or medic or doc, Ill ask my uncle about addiction in families hes a psych doc he would know alot, And we praise you on here for taking the steps to become a nurse its a very rewarding career, I think we all love it. Good Luck!

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Malanya, Im not trying to be judgemental on here, but we get so much of this you know what, it just gets old and we need some humor, I am so sorry about your father, I would not know thankfully almost everyone in my family is a nurse or medic or doc, Ill ask my uncle about addiction in families hes a psych doc he would know alot, And we praise you on here for taking the steps to become a nurse its a very rewarding career, I think we all love it. Good Luck!

I apologize if my question brought down the mood.

If you don't laugh you cry, I know that. I certainly wasn't trying to tell anyone not to laugh. Believe me on that, please.

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Specializes in ER/SICU/Med-Surg/Ortho/Trauma/Flight.

Malanya, no prob. pm me anytime. Im a friend Im here to listen.

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Specializes in ICU, Pedi, Education.
I'm fairly large (4'11 and 180) so I can understand the issue. Like other people said, sounds like the needle didn't actually get into muscle. Fortunately I don't have much fat over my glutes as opposed to my thighs and stomach, so I haven't had that problem.

My father is an IV drug user, so I agree here. My dad now has a port, but in the past he's told doctors which veins still were good. He's been able to find doctors who are somewhat sympathetic to his situation (now been HIV+ for over 15 years and full blown for 10) and while they won't write him narcs or other high abuse potential drugs, they keep track of his condition closely. Dad actually hasn't done any IV drugs for several years -- he switched from IV meth to crack. *sigh* From his experiences I would agree with most of the people on here -- if you're an IV user the other methods of getting the drug just aren't what the person is looking for. Dad has said often enough that he'd never snort meth, that only the IV buzz gives him what he wants. In your sister's case it wasn't what she WANTED, it was what she needed -- the pain relief, not the buzz, and the needle just couldn't get into the muscle.

When he was in jail a few years ago, they needed to draw blood but didn't have the stuff needed to flush his port. The jail nurse tried to stick him once, then handed him the rig and had him do it himself. He got it first try, but not on the vein the nurse went to first.

I keep telling him he ought to get clean and after he'd been clean long enough that they'd hire him, become a tech and work at a blood bank doing withdraws. But he's too caught up in his addiction to even try to make something good of himself, and being HIV+ they might not want him.

--------

I have a question for you full nurses (I'm just a student). In your experience, are the families of junkies more or less likely to become addicts themselves?

I feel very lucky that I went to Alateen. Alateen is not just designed to help a person deal with their parents' addictions, but also to help recognize addictive thoughts and patterns of behavior in themselves. Because of those lessons, I'm considered by most of the people I grew up with to be the "furthest thing away from an addict".

I occasionally drink, but only with friends, and usually only on NYE. I may have a glass of wine if I go out to dinner, and it's a special occasion. From the first time I ever drank, I set rules for myself -- I would not ever keep alcohol in my home, I would not drink except wine or mixed drinks at a bar or restaurant, I would not drink alone, I would never drink without eating something more than an appetizer, and I would not drink if I was in a bad mood or was trying to escape a problem. I've followed those rules. If a doctor gives me medication I know can be habit-forming, I tell them about my father's addiction and request that they try to find a medicine that's not habit-forming. When they can't, I try to take the least I can, for the least time I can. I think I've done pretty well. I'm also with a person who does not drink at all except a half-glass of wine occasionally when we go out.

But in your experience, is this a common way for the family members to act, or is it more common for them to fall into the same trap?

For me, I would never want to put people who cared about me through the hell that my father's addiction did to our family. I would hope that others would have the same thoughts.

Thanks!

As a daughter of an addict, I share your fears. My father "self-medicated" his bi-polar disorder for many years with ETOH, pot, and other drugs. Both of my grandfathers were alcoholics as well. I do believe it puts one at higher risk for addiction both through genetics and environment.

The thing to remember is that addiction can hit you in many different forms. I have always been very careful about ETOH and never used illegal drugs or prescription drugs that were not prescribed to me. However, I am in recovery for anorexia nervosa. I have spent over 15 years struggling with eating diorder behaviors and I had no idea that stopping ED behaviors could be just as much of a struggle as fighting ETOH addiction. So, don't forget there are SO many things that can cause that "addiction" gene to be activated...from cleaning (my husband would LOVE that), to food, to work, to school (as hard it is to imagine to most people...I am addicted to going to school), to exercise, and so many other things.

The simple fact that you are very aware of how your history can affect your present is FANTASTIC!!!:yeah:

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Specializes in Hospice, ER.

I just love those folks who come in and tell you what drug they want, the dose, the route, ....hold on...they know the 5 rights as well as we do! I also ask the junkies where the good veins are. Why was my time poking around when they know exactly where to stick. The med request is very shortly followed up with requests for food, drinks, phones...all in short and very predictable order.

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Specializes in ER.

BS is BS everwhere. Kills me how these individuals actually think that this is the first time we have heard these kinds of comments. LOL

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