Rocephin Question

[janat]

I work in a new primary care practice that treats alot of adolescents and young adults. For more serious or recurrent ear infections and upper respiratory infections, our doctor often prescribes 1 Gram IM Rocephin along with IM Decadron. The Rocephin is pretty tough for most patients to take, especially teenagers. I use 1% lido, which makes about 3.3ml which I give in one hip, and the Decadron in the other hip. Any suggestions or ideas on how to make this more tolerable for the patient?

[klone, MSN, RN]

I don't know, but my 13yo just got IM Rocephin a few weeks ago for an infected toe (he's not very compliant on taking PO antibiotics). Holy guacamole, I had no idea it was so painful! He was crying hysterically for about two hours, until the motrin and tylenol kicked in and he was able to fall asleep. I had no experience with IM Rocephin, so I didn't realize it was so painful. The fact that the MA told me it was reconstituted in Lidocaine should have tipped me off, I guess. He actually had a vagal response and had to sit down in the lobby with some OJ for about 10 minutes after his appointment.

[Chin up]

Once mixed with lido, I always divide and give each cheek, equal treatment...even though you are sticking twice, they like it better that way.

[rkitty198, BSN, RN]

I had a toe infection two years ago which required this. I didn't feel a thing except for the needle going into my skin. I guess we all have different tolerances for pain.

[LilDolphin]

What helps my pts who get Rocephin IM is 15 min before I give the inj I give them Ibuprofen (if they have a PRN order for it) and then when I mix the Lido c the Rocephin I let it sit for 10 min before i inj the med. My pts have said that does help to ease the pain/disc.

[lckrn2pa]

Stomp their foot before you give it, they will be more worried about the foot. Rocephin hurts, no way around it really. My wife has had it with and without lido and she swears the lido made it hurt more than without.

[leslie :-D]

Rocephin hurts, no way around it really. My wife has had it with and without lido and she swears the lido made it hurt more than without.

yep, i've heard the same complaints...

that lido made it worse.

i'm with you, it's a nasty drug (but works beautifully!) and there's no way around it.

leslie

[rkitty198, BSN, RN]

Addition to my prior post-

I had it without lido- my MD said it burns more with lido than without.

[mybrowneyedgirl, BSN, RN]

Decadron can be given orally. Check into it. And I agree. Divide the rocephin

[Guest717236]

Once mixed with lido, I always divide and give each cheek, equal treatment...even though you are sticking twice, they like it better that way.

This is close to what we used to do in Pedi. Except the MD wanted 2 nurses.

We would coordinate and give the injections one on the Left thigh and one on Right

thigh at the exact same time. The MD felt this avoided the time delay for

doing the shots separately. (We did not use Lido)

[FutureRN9]

Decadron can be given orally. Check into it. And I agree. Divide the rocephin

I would not recommend Decadron PO. I speak from experience. It is absolutely the MOST NASTY medicine I have ever tasted. The nurse that gave it to me told me that they use the same formula for both IM and PO routes. I don't know if I can even describe the taste for you. Also, the taste remained in my mouth for several hours. I would take a shot anyday over PO Decadron again.

[EDrunnerRN]

I ALWAYS, ALWAYS dilute with Lido. When administering this medication I do a slow push allowing the lido to numb the area, as that is the intention of the Lido. I also make sure the medication is well mixed by rolling it several times between hands. Word from the wise, never spill this medication on yourself...if you want to get back at someone spill this medication on them, accidentally of course