I had the strangest morphine reaction with my pt yesterday. Just quick background elderly asian pt, 3 day post op lap chole had been receiving 2 mg of morphine from past 3 days without any problems. In our facility we do not mix morphine with saline dilaudid is mandatory mix with 10 ml of ns but not morphine. So i gave my pt 2 of morphine for his pain, within 15 minutes he started severe shaking, chills, temp of 101.0, b/p 180/100, svt and hr of 130 to 140, sats of 82 on 4 litres of 02 audible loud wheezing. Called rapid response team pt was fine after 1 hour of intervention with iv laisx, solumedrol ,pepcid per our crazy house md, stat ekg and chest xray showed nothing. Everything came out negative. So what happen to my pt? Some doc said it might be morphine reaction but in morphine reaction your resp depresses, b/p falls they can have nausea, vomiting which is common with morphine reactions. Has anybody else seen this kind of reaction with morphine, md also said pt does not have bronchospasms and really nobody knew what happened????????????????????????????
I've seen this exact set of s/s in a person have a reaction to contrast. The pt. was hypertensive, tachycardic, hyperthermic, and was hallucinating. Solumedrol, dihpenhydramine and APAP took care of it.
I know this is probably going to sound strange but my first thought was possibly morphine not in the bottle, could have been a manufacturer or pharmacy error. Even if the bottle says morphine doesn't mean that's what was in there., although that would be probably rare, things do happen. Anyway that was my thought
Bear in mind that in the first/preliminary stages of shock (anaphylactic/allergic reaction) there is a compensatory phase where both BP and HR are elevated. Did this patient have a family or personal history of any allergic reactions or of asthma/reactive airway disease?
Virgo_RN, BSN, RN
3,543 Posts
I've seen this exact set of s/s in a person have a reaction to contrast. The pt. was hypertensive, tachycardic, hyperthermic, and was hallucinating. Solumedrol, dihpenhydramine and APAP took care of it.