subQ narcotics?

rninme · Jul 3, 2006

Was a new one for me too....just gave it for the first time last noc. According to the attending....morphine lasts longer and provides better pain control when given subQ....I must say, I was a little bit skeptical:uhoh3: ....but it worked well for my poor little bone CA patient.

Dixielee, BSN, RN · Jul 3, 2006

I don't think it is particularly common, but it does work. We had a poor guy who came to our ER almost weekly with horrible leg pain. He had the worst peripheral vascular disease I have seen and had already lost both legs below the knee. He was to the point where he had NO vascular access. We had tried central lines, EJ's, ports, etc. and he just didn't have anything left.

So we started giving him Dilaudid SubQ, and sent him on his way happy. We were certainly happy! It worked great. It may not be the preferred route for pain meds, but it worked for him!

ONSnrs · Jul 3, 2006

Wow,

Have never heard of SQ morphine or dilaudid injections, but am hoping to see them more on my floors, any solutions to pain in oncology are very welcome new additions.

KMSRN · Jul 3, 2006

Morphine can be given orally, intravenously, intrathecally, subcutaneously, and rectally. It can also be given IM but I sincerely hope no one is giving pain meds IM anymore. Morphine can also be given subcutaneously as a PCA or continuous infusion - the volume that can be given is limited. This information is readily available in any drug reference.

FastWater · Jul 3, 2006

Hello..

I work in gen Sx and we give pain meds SC. regularly. Most post op patients have orders for SC morphine. Some patients with poorly controlled pain or palliative care team involvement will order Dilaudid SC with and ISI route (butterfly needle placed SC and primed with medication). We don't do IV push on the floors - the SC route seems to work very well and most patients are very satisfied with their pain control (also have PCAs, PCEAs and Epidurals - SC narcotics work well after these routes are d/c).

Do other general Sx areas do IV push? Our unit does not do anything IV push.

churdlpn · Jul 3, 2006

Morphine can be given orally, intravenously, intrathecally, subcutaneously, and rectally. It can also be given IM but I sincerely hope no one is giving pain meds IM anymore. Morphine can also be given subcutaneously as a PCA or continuous infusion - the volume that can be given is limited. This information is readily available in any drug reference.

i have also given morphine as an inhalation to a man who hd lung ca.

CardioTrans, BSN, RN · Jul 3, 2006

Have also used Morphine and Dilaudid infusion pumps SQ. Also have given Morphine via inhalation. Worked very well for the patients.

jax · Jul 3, 2006

We use s/c morphine routinely on our ortho floor. 7.5mg-10mg for the big guys and 2.5mg-5mg for the little old ladies q3 hourly prn. It is against policy for us to give iv narcotics on the floor, is only permitted in icu/ccu/ed , ( areas with higher staff to pt. ratio).

nuangel1, BSN, RN · Jul 4, 2006

have given morphine sq.only time we use im meds is in fastrack where pts don't have iv's or don't need one .ie back pain

nursesarah · Jul 4, 2006

i give morphine and dilaudid regularly subcut. usually if the person is going to be requiring a lot of pain meds, i give it through a butterfly, tape it down and cap the end. then you can just push the morphine at regular intervals. works well for those people you cant get an IV site in and oyu dont want to be poking every 4 hrs.

Altra, BSN, RN · Jul 6, 2006

Morphine can be given orally, intravenously, intrathecally, subcutaneously, and rectally. It can also be given IM but I sincerely hope no one is giving pain meds IM anymore.

Can you elaborate on that - I've never seen pain meds given SQ, and I want to understand why IM is a bad idea.

Where I work, morphine or Dilaudid are sometimes given IM if it is a pt. with NO IV access and the situation doesn't warrant a central line. In a year in the ER, I've never seen pain meds given SQ - this was news to me.