sc morphine

I would like to ask: Is that necessary to try three doses of bolus sc morphine before starting sc morphine driver, thankyou.

I have no idea what you mean by "driver" - a continues drip? pump?

Generally speaking - not everybody who needs pain control or control for shortness of breath needs a continues administration. Sometimes people just need a dose or two to get symptoms under control and after that are fine with sublingual morphine.

There are cases where it is best to start cont medication right from the start without going through the usual titration and escalation protocols. Those include severe SOB in the setting of comfort measures only when a patient is taken off bipap or extubated with the goal to allow for a natural death.

Other than that it can look a bit excessive if you go from no narcotics to a continues drip.

You can't really bolus subcutaneous morphine because of the time needed for absorption.You can,however, depending upon the pump capabilites give a larger dose for the first few doses. Is the goal here to get the drug level up to get control of the pain? It is reasonable to give a dose IV,IM or even subcut prior to setting up a continuous method to receive the drug.

I would like to ask: Is that necessary to try three doses of bolus sc morphine before starting sc morphine driver, thankyou.

What are your thoughts?

we never bolus x3 as a routine requirement before starting continuous sc Morphine.

I quess you are using the term bolus as in giving a set dose through the subcut cannula as opposed to a continuous rate.