Here is the link to the news article about the Supreme Court's decision in the case against Wyeth about their failure to warn about the hazards of IV administration of Phenergan (promethazine).
http://abcnews.go.com/TheLaw/SCOTUS/comments?type=story&id=6939486
This continues to be a dangerous drug for IV administration. It requires the same level of expert skill as any other vesicant cancer chemotherapy agent, yet most nurses do not realize what is actually needed to safely administer this drug IV. To read more about what that entails see my blog entry
http://hadawayassociates.blogspot.com/2007/06/promethazine-injuries-continue.html
http://abcnews.go.com/TheLaw/SCOTUS/comments?type=story&id=6939486
This continues to be a dangerous drug for IV administration. It requires the same level of expert skill as any other vesicant cancer chemotherapy agent, yet most nurses do not realize what is actually needed to safely administer this drug IV. To read more about what that entails see my blog entry
http://hadawayassociates.blogspot.com/2007/06/promethazine-injuries-continue.html
Here's the NPR link:
http://www.npr.org/templates/story/story.php?storyId=101443146&sc=emaf
Mari Cordes, BS RN
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center
Barbara
I could not agree with you more! I have served as the expert on numerous legal cases involving this drug and have seen cases involving amputation. I think each hospital must examine their antiemetic protocols and eliminate the IV administration of this drug. I will always refuse to take it by the IV route.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I have thought more about what you said about the average bedside nurse and their competency with giving promethazine. I agree that most do not know how or take the time to perform the steps as I outlined. But this means that they are not meeting the national standard of practice and therefore will be held accountable for the outcomes. Any nurse, regardless of where they work, who accepts the responsibiity for performing any infusion therapy task must meet the standard. If they are unable, unwilling, or do not have the knowledge and skill needed, then they should not accept the responsibility. I realize this is a hard approach, but it is true for all tasks, procedures or practices that nurses do. The entire education and practice environment sets up nurses for these problems because nurses are not generally taught much, if anything, about infusion therapy practices in nursing school. Then when they go to their first job, they are at the mercy of whatever method the hospital has for teaching them. If that hospital has no infusion team, then there is no emphasis on these invasive danger tasks. The new graduate is left to be taught by another nurse who may not have any formal background in infusion therapy knowledge either. So this is a never-ending, self perpetuating problem of very low levels of knowledge and skills. Something has to be done to change this situation!
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Ann Zonderman, BSN, JD, CRNI, LHRM
Just for the busy folks, bottom line - Patient 7million dollar verdict upheld
Court held that the drug companies can not stand behind FDA protection. If warningis are not sufficient ... or if things change, drug makers must step up warnings.
Ann Zonderman, BSN, JD, CRNI
cathy rhodes
Does anyone have any information regarding infusing vanco, zosyn or flagyl, through an peripheral IV? We are trying to get our facility to run ithese drugs through a central line. Most of our restarts for IV's are because of these drugs.
cathy rhodes
Regarding Phenergan, I personally stopped giving it IV years ago, every patient has a muscle, and it is much safer IM. If the patient complains, I have gotten orders for other antiemetics.
Cathy, have you tried using the INS standards for peripheral IV medications as a basis to change your policy for these drugs?
Chris Cavanaugh, CRNI
Chris Cavanaugh, RN, BSN, CRNI, VA-BC