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?

[caroladybelle, BSN, RN]

Many people have more pain with the lido, but Rocephin IM is going to hurt no matter what.

(they occasionally try the old lido before an IV stick- I personally find the lido is more painful then the stick)

[mitchsmom]

Wow... I didn't know rocephin was especially painful (I don't think I've ever given it)... my son got it in the ER about a year ago (with a couple of other shots) and didn't have any particular reaction or comment to it.

[Forever Sunshine, ASN, RN]

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.

I'll remember that next time I have a resident on IM Rocephin.

The first time I had an order for IM Rocephin the offgoing nurse gave me a heads up to reconstitute it with lidocaine or else it will be very painful. Sure enough, the pharmacy didn't send it. So I made sure not to give the Rocephin until there was lidocaine.

[Anisettes, BSN, RN]

I had IM Rocephin about 10 years ago and don't remember it being very painful at all. I do wonder, though if it's like the reactions I've seen with IV propofol for surgical induction - patients either don't feel anything at all (like me) or it's VERY painful with people actually thrashing around - there seems to be no middle ground with either - it's all or nothing.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

Both Rocphin in water and in Lido hurt. The difference is the Lidocaine will numb the area and decrease the long term pain. At least that's the explanation I got.

[nurseinprogress12]

I work in a primary care setting also and I give Rocephin alot as well. I give it very slowly and I can't tell you how many patients I have had say "Oh my gosh that was so much better". It really helps alot. :)

[tyvin, BSN, RN]

It's a fact that Rocephin is more effective when administered IV then IM. Even if it's only one shot it's better to get an order for a saline lock so the med can be administered IV. That way the whole mess about the painful shot is avoided.

Of course is the stick of an IV better then the stick on the IM...I would absolutely take the IV.

[GM2RN]

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.

We always give decadron PO to kids but mix it with another liquid med such as tylenol, if ordered, or mix it with a small amount of juice. I've never had a problem with it that way.

[NicuGal, MSN, RN]

It hurts like a mother! I've had it for a really bad strep infection and it was mixed with lido! My daughter go it once when she was 4 for a really bad ear infection and she kept spitting the oral stuff out. I felt awful But they did the two nurse method...but still, it was both her legs NO way around it...it hurts no matter what!

[GM2RN]

Wow...I've never gotten an injection of rocephin myself, but I've given quite a few and have seriously never had a patient tell me that it hurt like that.

[MisMatch, LPN]

I gave my first injection of rocephin a couple of days ago. It was mixed with lidocane. Person never even flinched, but then they are comatose.

I appreciate reading this thread before I give it to someone who can feel it!

[LACA, BSN, LPN, RN]

i've given and gotten rocephin im injections....i've always diluted it with lidocaine, i've been told that it stings either way. i've had patients react from one extreme to the other...some never flinch, some scream like little girls (oddly enough, this mostly happened with grown men, no joke.) i've given it to a few peds patients, all of them cried, but stopped within 5 minutes of the shot.

as for getting it myself, i think it hurts, but its not unbearable....