Reply to Hospital gave FIL Narcan after administering too many pain meds...

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]Nurse here who has given Narcan a few times, none due to medical negligence.  And I'm certainly not one to say negligence doesn't occur, as I've seen it first hand.

All the experiences I've had given it have been for reasons 2358 stated.  They've been given an appropriate dose, maybe on the high end of appropriate but still ok, but are too sedated.  I've never had to give it for respiratory distress, all the times have been basically because a patient becomes so sedated they aren't responding appropriately.  Managing post op pain in elderly can be difficult.

I wouldn't immediately jump to medical negligence or respiratory problems. What he should do is request all his records so he has drug, dose, and time administered. [/quote]
What does “intended side effects of narcotics” mean? If I’m reading your post correctly 2358’s unintended reference is what you’re saying where a patient receives the appropriate dosage but for whatever reason doesn’t respond well.

Also, if a patient is too sedated, are they not able to eventually come out of that state on their own?

TIA.[/quote]

Sorry I'm half asleep with a cranky baby in my arm so hopefully my answer makes some sense.  I misread pps post but even with narcotics part of the intended side effect is for the patient to have a somewhat sedative effect.  The unintended side effect is that they become too sedated. And yes, at times they can come out of it on their own, but it's not really worth the risk.  If a patient is simply obtunded or heavily sedated but their vital signs are intact, we aren't emergently acting. But its a bit of a bigger picture thing. If they are arousable and responsive but lethargic (picture someone still coming out of surgery) we will probably closely monitor. However if we are sternal rubbing them and they are minimally responsive or they aren't able to keep their eyes open, they run thr risk of deteriorating. And it's much less dangerous to treat someone who is obtunded vs someone who is obtunded and now is breathing slowlu and shallow, a HR that's getting lower, and a BP that's dropping.

Pain control is a very fickle thing because its impossible to determine what someone's pain level is. A patient who complains of 10/10 pain despite receiving meds and appearing to be resting comfortably can't be blown off because they dont appear to be in 10/10 pain.

I'd say 75% of the times I've been called to the bedside of a patient who has needed Narcan its because the patient is either elderly or has another condition which causes the meds not to process properly.
20% has been people who have taken illicit drugs as well or who have pocketed the pain meds and then taken a bunch at once
5% has been for no known reason.  [/quote]

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