CADD PAIN PUMP PLUS
Plus it's invasive, you are sticking someone every three days or more often. Although we own our pumps, the meds are expensive and maintaining a sub Q site has a labor cost associated with it. We believe that it's our ethical and legal obligation to make whatever changes are necessary until the patient indicates that the pain is at a level acceptable to the patient.
CADD PAIN PUMP PROFESSIONAL
My professional experience has shown me otherwise. I'm also not a big fan of Durgesic in situations where rapid titration is likely to be necessary, say someone who has widely fluctuating pain levels.Īnd just an FYI, don't think that if you have a home situation where you think diversion is an issue that it's not possible to divert out of a CADD pump. Hospice patients often have poor venous access and even if it's viable, it's a stick every three days. I've never known us to use a peripheral line other than a PICC, which as we all know is considered a central line. We will use an existing PICC line if there is one, and sometimes place one if there is absolutely no SQ tissue and we have tried a SQ with poor results. We use SQ sets, they are like a tiny Huber, 25g 1/2". With that said, we use our own CADD type pumps where injectable analgesia is indicated. I've actually had good results in a pinch filling gel caps with Roxanol and giving it rectally, as much as 60mg (3ml) Q2. Anyhow good luck with that.Īs the CHPN curriculum suggests, we tend to use the gut if it's working, either PO or PR. Plus if he's wincing its obvious he needs somewhat of an increase.which leads me to another reason I like the CADD pumps.the fact it tells you how many prn doses they've recieved and how many were attempted. Of course most of the time we don't put our pts on pumps until they are unable to swallow. Our doc transfers all the doses of pain meds into whatever is going to be in the pump and d/cs the other pain meds. Also, i'm surprised your pt still has his duragesic. We use the Grasby also, and while I find that easier to work with since i've used it more, it does not have a lockout as far as the prn doses go since its just a syringe driver. I think the CADD pumps are great, especially in home settings where you have other family members "stealing" pt pain meds. This is in addition to the scheduled dosing. Ours has a screen that says "demand" where you can set the prn dosing, then after that screen it lets you set the lockout. My CADD (the Legacy) does not have a PCA attachment-no pushing buttons for this guy, his scheduled dose is programed.īut he really does seem to need it, and I don't see him surviving long enough to change out the cassette (which is supposed to last a week). He is on MS 1 mg IV q 1 hr cont infusion plus 2 mg IV push q 20 minutes for breakthrough. Well, I admitted my patient with his CADD pump.
It's one of the things I love about methadone, it also helps nerve pain. These things would not make him groggy, but could give hime huge help. I did talk with him about kicking the crap out of the pain before it gets a good grip, maybe that will help him."Īt the risk of being too picky, what else is he on and what type of pain is he having? IV meds are still helped by adjuncts like neurontin and NSAIDS and dexamethasone for inflammation. Would rather tolerate the discomfort.Īt 27, he seems to be fighting dying while being OK with his impending death. He does not want to be out of control, doesn't want to feel at all fuzzy. I didn't see any of the usual flags for concern about "loose" morphine in the house (makes me wonder why there's little concern for Roxanol at twice the strength, but worry about other forms ), and I did also ask.Īs for increasing the dosage, he resists that. The wife is very young also, but has learned a lot and the onco has confidence in her.
I thought they said he uses the prn a lot, turns out it is still a little rare. This CADD is used generally for chemo-the onco's office loaned it. "There doesn't seem to be a way to program in the prn doses.
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