The Passing of Demerol

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There is plenty of literature stating the cons of Demerol use for pain management but usage still remains high in the hospital setting. I have had little success in my career to change physicians ordering practices except when I can demonstrate the side effects or poor outcomes produced by Demerol on a patient-by-patient basis. It seems not to matter the short duration of action; induced confusion in the elderly or the potential Demerol has to produce nuerotoxicity due to the accumulation of normeperidine.

As nurses it is our duty to be an advocate for our patients. To help ensure patients receive the best possible care we as nurses need to arm ourselves with knowledge. It is important to possess the basic concepts of pain management to accurately assess and document your patient’s pain and to know the classifications of pain. The nurse must understand basic pharmacologic pain management principles including the use of an equianalgesic table. Working with the medical staff to develop pain management protocols can help decrease Demerol usage and provide an effective pain management program in your hospital.

Demerol seems to be dying a slow death but as hospitals and healthcare workers embrace evident based medicine it is only a matter of time when this “lumbering dinosaur” will be come extinct.

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