An informal discussion of emergency nurses' current clinical practice: what's new and what works. Danger with use of intravenous promethazine in the emergency department.

摘要

Lately, I have observed many ED nurses delivering pro-methazine intravenously in the emergency department. I have seen promethazine used for allergic reactions, for the relief of pruritus resulting from various dermatologic conditions, and for nausea and vomiting of various etiologies, such as motion sickness, radiation sickness, anesthesia, and gastroenteritis. Promethazine also is used as a sedative, hypnotic, and tranquilizer in patients with insomnia, nervousness, anxiety, and tension. Unfortunately, because it is so commonly used, clinicians sometimes tend to deliver it in a casual manner, failing to take into consideration the risks involved in its use. For example, promethazine often is given to a patient with acute abdominal pain in conjunction with a narcotic before going to the operating room for an appendectomy. Often these patients are not receiving any intravenous fluid and may have "medlock" access prior to being sent to the operating room.