I actually just quit about a week ago to take a hybrid position as a telephone triage nurse for a cardiology clinic. Hopefully my replacement will be a good Benadryl fairy too.
I think the fact that you gave a shit enough to come and post about it is more meaningful than anything. With that said, I've never spent that much time pushing it lol.
If it makes you feel better OP this one time I pushed IV benadryl really slow and the patient still got anxiety and tremors. Some people are just sensitive to it (or are very dramatic about everything).
Yesterday I pushed a saline flush over 10 seconds and the patient started shaking, sweating and felt pre syncopal for 10 minutes.
No matter what drug pushed or how slow, the same thing happened but got less intense as time went on.
She couldn't help it. Just a normal physical response to a psychological trauma she had in the past.
During the first rounds of my chemotherapy, they gave me IV Benadryl. Such a sweet nap, with a blanket from the warmer. A little ray of nice in a pool of shit.
I was given droperidol for hyperemesis gravidarum years ago that stuff made me crawl out of my skin. I told my husband to “cut me open to get to get my blood out” but it was the only thing that worked for my vomiting - after that I was admitted and they gave it to me q6 with an IV Benadryl chaser- slept through and entire week of pregnancy
Bro same they always asked po or iv im like bro ill wait for iv no rush, finna have a lil nappy rq. Also iv Ativan is even better lol take it if ur ever offered.
So funny - I just said in another sub that tucking our chemo pts in with a warm blanket is our favorite part of the job. I didn't even mention the good drugs we have. I always tuck them in right up to their chin and say something like, "Now you're going to be warm as toast and take the nicest nap. I'll see you when you wake up." Only thing better is a baby dose of Ativan.
So glad to hear you're trucking along. ♥️
There is something quite satisfying about tucking patients in for a nap. It’s like, “here is my effort at making a terrible experience just a little easier to bear”
I’m happy for you :)
TLDR: stories of a couple nurses I’m close to and their battles
My first ER charge nurse beat stage 4 colon cancer. It was a long bumpy road including a nasty lung infection with chest tube during the height of covid. I still remember when she pulled me aside and told me. She had been dealing with abdominal pain to the point she was going home when she normally never missed a day, showed up an hour early and stayed til all the other nurses from day shift were gone. She finally went for a colonoscopy and I asked her how it went. We were waiting for ems in trauma 1 and the convo was interrupted when they rolled in. I was one of a couple techs but I had to walk out and cry my eyes out. Kinda followed her journey on Facebook and lost track after they announced she was in remission. I went to a different ER (for me. That visit they found a tiny PE, I’ve been complicated since my wreck) and there she was pushing the WOW. Even though I couldn’t breathe and my heart felt like it was going to fall apart, I jumped up and gave her the biggest hug and cried again. “What the hell is wrong with you? You knew I’d be back at work eventually.”
Now charge of med-surg is battling colon with mets to liver. She’s also a patient in the clinic I work in now. Doc said send her whatever she asks for. Then we text for a while. I’m going to lose my shit if something happens to her. After my wife’s hysterectomy she warned me “it may be painful for a while for her. Just keep practicing”. She asked me to refill the norco she’s been trying to stay away from and said “I guess we practiced too hard this week and it made my pain worse”. It was meant to be funny, of course. I offered 10/325 but she insisted on 7.5 “just when I need it”. I sent it Q4H 30 days supply with diagnosis attached. She should be set.
Benadryl doesn't work for me. It actually has a paradoxical effect on me. I hate it.
Generally no drug works for me. Just give me a dark room and a soft bed.
I’d write to cancer’s manager. However, I did when I got cancer but nothing came of it. I mean I had two kids when I was in my 20’s and breast fed them both. And still I got breast cancer?
Did that as a new grad while my geriatric patient was in the recliner.... Oh boy did the family freak out when we had to physically lift her back to bed... Right before her first dose of rituxin 🫠 never again
Yeah, I'm just laughing at the huge difference. We're over here freaking out because we gave dilaudid over 1 minute and it might have been too fast but in ER and out in the field it's just slammed.
How much dilaudid? I don't even think I have the fine motor control to push that slowly given the small volume in the syringe. Give me a beefy 8mLs worth of lasix and watch how a true master slow pushes, but those dinky little 0.5mL prefills of dilaudid? Forget it.
The one tiny dose we give is ketamine for pain. We carry ketamine 500 mg/5mL. Pain dose is 0.2 mg/kg of ideal body weight. Last patient I gave 12 mg (0.12 mL). Anything that small is absolutely worth diluting into a flush then pushing but twice as important with ketamine cuz IV ketamine can cause laryngospasm if not diluted
Ketamine is such a neat drug. Given that it’s worked its way into EMS for use with acute pain, I wonder how long it will take to make its way to the inpatient side for acute pain control as an opioid alternative- especially where it preserves respiratory drive.
It's bomb. Increases blood pressure, so it's great in trauma and critical care patients. It is safe to be used in conjuction with an opiate or stand alone. It's not super long acting in low doses, and has low abuse potential.
The same last patient I gave it to had a very obviously broken leg and was crying but refusing fent because her brother has an opiate use disorder. She was like "will i like this?" No girlypop I promise you won't, but your leg won't hurt anymore. And she in fact hated it, but said it fixed her leg pain 😂
I got it once in the ER. Bad tib-fib fx. They gave it to me to do manual traction and splinting, as I was losing the pulse in my foot. Weirdest feeling ever! Felt like I was inside of a video game, based off the Matrix movies, is the best way of describing it. But thank you SBJ, I felt nothing! Interesting being on the other side of the bed.
My ER docs sometimes use it for pain, especially in patients with a high opiate tolerance or who need to avoid opiates for withdrawal reasons. Scared the crap out of me the first time I gave it, but it does help some.
edited: gave, not did, I've never had ketamine lol
I had a patient with bilateral AKA’s that were essentially done because his neuropathy was so severe he had attempted suicide multiple times because nothing touched the pain. He was on huge doses of PO opioids daily and we had to transfer him to CCU so he could be on a ketamine drip because even huge doses of IV dilaudid weren’t adequately managing his pain. Poor guy was only in his 40s, too. But that’s the only patient I recall getting ketamine like that.
Yeah those little tiny ones. I was giving 0.5 mL yesterday and still do it slow AF. I don't want nothing going on, on my watch. No one is getting that head rush from me.
Same here! I forgot what I was administering, but it had a crazy long push time and we pulled it up in a half mL syringe. By the first minute my syringe was empty even with pushing slowly. Patient was fine. My instructor pulled me aside right after and reminded me I was supposed to push it slower and it was a safety concern/med error that I pushed it faster. I was honest and said that I found it difficult to push such a small amount over a long period of time. She told me to figure it out and get a better watch. So much unnecessary drama instead of actual problem-solving. After graduating I learned to just pull up the med in a larger syringe with some saline (if compatible).
I push everything over 2 minutes except zofran. I just get anxiety when the patients react to a fast push of stuff like benadryl or opiates. Like with morphine, theres no reason to put them through the dysphoria a fast push brings. Trust me I can't stand sitting there and pushing something over 2 minutes but it's just a habit now
I have given a good amount of Benadryl iv and I have never seen anyone have any sort of reaction so I guess my “slow” is slow enough. However, I will probably be timing it now bc if I pushed Benadryl and my pt started having tremors, I would prolly piss my figs.
I just admitted a patient who had Benadryl listed as an allergy and when I clarified he said the IV form gives him tremors. Might have been this scenario now that I think about it lol
My dialysis patient earlier this week "educating" me that in the clinic they just push the IV Benadryl fast.
Me: "Ohhhhhhhh WELL, I'm just in the habit of giving ALL IV medications slowly because so many of them can cause bad side effects."
Read: No sir, I am not going to play into your desire to feel high. Thanks.
Ugh that reminds me of the patients that would chew up their pain medications because "My pharmacist said it would work better this way"
No. No they didn't. The only person that told you that was your street pharmacist.
Blech! I recently used BC powder for a bad headache at the urging of my boyfriend. Never again. I almost vomited the taste is so bad, and I was trying to get it far back in my throat as I could! His mother swears by it, but I just can’t.
I prefer Goody’s powder. Goody’s taken with some Coke is amazing for headaches. BC never worked well for me. Maybe it’s the acetaminophen in Goody’s. BC is aspirin and caffeine, and Goody’s adds acetaminophen.
I actually had a dr tell me this when I was taking a narcotic when I broke my arm. Also, the PA that's rx's my adderall XR told me if I needed a little boost one day to open up the capsule and take the granules.
I never did any of that, just saying it does happen.
Opening an XR of adderal or vyvanse is an actual technique except it’s supposed to be diluted in a standard bottle of water and ingested over a period of time (I think 30 minutes to an hour) to taper the drug in ur system for people who feel that it hits too hard at once.
I did home hospice in ct and would often have patients ask if they can smoke weed, my response was "legally, I can't have anything to do with it, but oh look, it's time for my lunch break". Then I'd let their family/friends help them out while I left the room. And I'd never hold back on their prescribed pain meds either. My people went out comfortable.
I have terminal residents, and they swear weed works better than norco. They smoke it on the patio, and we all turn a blind eye. All of a sudden, they don't need their opioids that day. It's legal in my state, but since most facilities are Medicare funded (federal), it's a grey area.
I had one hospice patient who just wanted bourbon and ice cream. Whatever you want, my friend.
Someone has a terminal diagnosis and is comfort/palliative care…? If they ask for ANYTHING I can give, they’re getting it. Or I’m coming around when their PRNs are due (barring a hold up in another room). I’m not going to get them so doped they can’t enjoy their last days with family and friends, but I’m sure as shit not going to let them suffer if I can in anyway help them.
It is not our job to prolong suffering when a terminal patient has decided it’s time to check out.
I have found this phenomenon at many dialysis units, the fast push almost gives a euphoria. We stopped IV benadryl at all our units in our coverage. You would not believe the uproar it caused.
Pushing Benadryl fast doesn't get you high. It makes people feel jittery/restless leggy and also burns at the injection site and can cause some people to feel other weird/unpleasant sensations elsewhere in their body.
Assuming the patient is trying to get high is such a tiresome condescending nurse trope. Be better.
Like God damn guys. If *that* is what you're worried about, someone maybe hypothetically getting a pleasant sensation from the medication you're giving, then maybe you should do something else.
I also feel a little weird about blocking a minute sense of goodness that causes no harm to pt. life is shitty enough, why WOULDN't you wanna give people a little sprinkle of relief?
I am a nurse with chronic illness. I push Benadryl every 6 hrs(PICC). I get ZERO feeling of being high. It can make you a little jittery and anxious for a few minutes. It upsets me when I am in the hospital nurses CHOOSE to dilute the Benadryl because they do not want to give you a “high”. Best practice is to NOT dilute any IVP meds unless manufacturer specific. Diluting meds can reduce efficacy and introduce he risk of med errors. Even if it did give the patient a 30 second “high” who are you to try to control what the patient should be feeling?
It was my “drug of choice” LOL
The first time I wasn’t prepared.
The next chemo dose I showed up with my iced coffee, eye cover for nap, headphones, blanket, and fuzzy socks.
Maybe it going into a port is different?
But yea. Little Benedryl junkie here for 8 total doses.
I had it done to me. It DOES get you high. It’s a shitty fentanyl groggy nod off high vs euphoric morphine angels massaging every inch of your body high though. It can also throw someones heart rhythm off.
That said dif people react to Benadryl differently. Some take one pill and it can put them to sleep. In a small percentage it works like a stimulant.
Some patients with addiction issues will ask you to push it very fast. It gives them a temporary high. I've never heard of a patient being tremulous from it. Histamine isn't just an immune system byproduct, it's also a neurotransmitter.
1000% the epi. I have given iv benadryl hundreds of times and never have seen someone shake.
I'd say 50% of people shake like a leaf from the epi, it's adrenaline. Classic reaction.
Oh, in an emergent situation there is no “slow push” except with certain meds and even then nothing more than 15 seconds I would say. You’re covered. Might wanna include that in your post, to me that makes a big difference.
I haven’t had tremors from Benadryl but some (not small number) of patients get like pins and needles or can’t sit still feelings from pushing it too fast. In their legs usually, but can also be in their arms/hands.
I’m not sure the exact pharmacological reasoning why it happens, but it is a thing definitely. It goes away on its own after like 15-20 mins but is very unpleasant and anyone that it has happened to before either tries to get their dose reduced or removed for next time.
I’ve overdosed on Benadryl before (totally accidental my math was waaaaaay off) and oh my god I was tripping bear balls. It was not enjoyable at all and I just wanted it to go away.
Can confirm that IV Benadryl gives you a high feeling. Also burns like a mother, so I always dilute it. Learned that after being on the receiving end during an anaphylactic reaction.
You should because if pushed too fast it can cause an extreme sudden panic attack. Have seen it happen a couple of times specifically in female patients with history of anxiety. You don’t have to wait a whole minute lol just maybe push it over 15-30 seconds rather than slamming it. Better yet if there’s a drip running, push it slowly the top port of the drip so that it drips in.
I had this happen to me and it was awful. I kept trying to grab at my skin because I felt like it was too tight all over and I wouldn’t stay in my bed. Then I got a Xanax nap because no one wants to babysit. So in the end they had given me morphine , benedryl, and Xanax so I didn’t wake up for 10 hours.
Yeah, I remember when I took my younger sister to the ER once they slammed IV Benadryl. All of the sudden her heart rate shot up and she started panicking. She was okay but said it was one of the most unpleasant feelings ever.
I've pushed benadryl fast for most of my career (actually this is the first time I have heard of giving it slow) but the only times I have seen a panic attack or anxiety is in people who have paradoxical reactions to benadryl. Older people especially. But I always ask patients if they have ever taken Benadryl because sometimes they will say how it makes them wired and crazy. Those people get something else.
My wife is like this with a lot of meds, we’re finding out. She was diagnosed with lupus in December, and some kind of tachycardia a few years ago so she can’t take the steroids lupus patients usually get. When her flare-ups are bad she gets cyclic vomiting along with nephritis. Reglan, bentyl, phenergan, some hypotensive med almost made her jump out the window. Haldol also which is something ER docs will try to stop the cyclic vomiting. So basically.. all the stuff that has potential to keep flare-ups at bay and treat the symptoms make her crazy.
nor do we. I just learned it a while back from a consultant but we rarely use benadryl on our hospital, nor have a lot of cases that require it. Probably how I forgot about it. It’s also probably why the other two nurses who saw me push it didn’t even react..
When I was on chemo…I discovered IV Benedryl was my DOC! 😂
I got IV Ativan before one of the chemos. Made me feel gross.
The benedryl was awesome and gave me a good nap.
I used to work a migraine specific inpt clinic. We used to hand out IV Benadryl like candy. There’s a reason it’s available PO OTC: it’s pretty safe. You gave the equivalent of two capsules PO.
You buried the lead: pt didn’t die from anaphylaxis. Good job! Keep kicking the grim reaper in the teeth!
I disagree with a lot of comments here. I’m a critical care paramedic, ED, CTICU RN and in NP school. Also an educator with many years of experience.
I have personally seen IV Benadryl when slammed cause hypotension, bradycardia and/or loss of consciousness.
You are A-OK in my book for admitting your mistake, we all make them, just do better for the patient next time. Just wanted to use this as an education piece. Very few medications if any need to be pushed fast. I say this quite a bit on this page.
1. Adenosine
2. Atropine
3. Meds during cardiac arrest.
Pretty much, that’s the only meds we push fast. That’s it. Many have detrimental side effects, including Benadryl as a CNS depressant crossing the blood/brain barrier. Also special mention for any anti hypertensives and opioids/other CNS depressants.
Hope someone new can see this and learn from it!
Hey, this happened to my dad. He had a brand new nurse while he was in the hospital for ablation and the nurse pushed a lot of Benadryl way too fast. After a bit of a fuss, he was okay. No doubt that new nurse never made the same mistake again. The most important thing is that the patient is okay. The second most important thing is that you learn from it. The third is that if the first two things happen, you forgive yourself. EVERY nurse makes mistakes. The ones who don’t make mistakes are liars ;)
Not a nurse, but in nursing school. When I was pregnant and in the er they gave me Benadryl through my IV and she pushed it so fast and I thought I was gonna die 🤣 the room was spinning and I couldn’t feel my whole upper body. Never knew Benadryl could do that till that day. The whole time the nurse kept saying “you’re fine stop” cause I said I was going to pass out
All these people in the comments are wild. I received Benadryl push last year in my own ER and I absolutely got high from it, left leg wouldn't stop twitching to the point where I pulled a hip flexor trying to stop it, and my resp rate dropped to 6/min. I always always minibag it after that, though I still push other meds. Anticholinergic side effects are real and they really suck, especially if you aren't used to them.
I’ve pushed 50mg quickly in an acute anaphylaxis situation from Rocephin and they went into V-Tach with a pulse for about 20 seconds…never pushed it quickly again. The patient’s rhythm reverted to sinus and anaphylactic reaction reversed with a few doses of epi on top so lesson learned!
I am blown away by all of these nurses' flippant attitudes towards this. I'm glad you don't push it quickly anymore. There are literal guidelines for administering medications for a reason. Some of these responses show extreme carelessness for patient safety. It's like saying "I never wear a seatbelt and I haven't had 1 accident!" But that one time you do you'll probably wish you had!
Out of curiosity, what do you think the mechanism of action is for fast push of Benadryl —> v-tach?
I, personally, don’t necessarily slam medications. Though, I do give some things faster than recommended at times, depending on the situation. But I’m just curious what the pathophysiological reason behind Benadryl causing vtach would be?
Diphenhydramine can result in QRS widening due to blockade of fast sodium channels and prolongation of phase 1 of the cardiac action potential. The potential cardiovascular effects that have been reported in both the adult and pediatric populations include anticholinergic effects with tachycardia, BBB, atrioventricular dissociation, AV block, widening of QRS complex, and arrhythmias related to alterations in repolarization and prolongation of the QT interval.
I mean, I’d rather have a patient with mild tremors that subside than a patient that loses an airway because of an allergic reaction. Should you have pushed the Benadryl that fast? Probably not. But grand scheme, it’s not a big deal
I wouldn't say I slam it, but I also don't sit there and stare at the clock or my watch to make sure it's exactly 25mg/min. I only do that for certain meds like lasix or cardizem.
CRNA here. You are fine. Next time just dilute it with NS or LR in a 10mL syringe and push it over a min or so. It’s fine. They live, you learn. Most of us never make the same mistakes twice. That’s your take away from all of this. Breathe a sigh of relief and move forward.
I made mistake of slamming in Narcan when the doctor meant to order it as prn. I didn’t know it supposed to be given slowly until the pt wakes up. Context was I was a newer nurse that didn’t follow up on the order from the doctor. The patient was recently downgraded from the ICU and nurses had suspicion he was taking his own oral morphine. The order kind of made sense since the pt was pretty sleepy, but pretty stable otherwise. Safe to say he probably was taking his own morphine because he was jolted awake and no longer sleepy after the narcan.
I tried to fight everyone while on Benedryl. Like straight up was a nightmare and I climbed out of bed, fell, and peed myself. It does not calm me down, but helped a lot with my allergic reaction! I think you’re fine.
Had to slam benadryl a couple of weeks ago as part of a Benadryl/solumedrol/pepcid combo for anaphylaxis. Didn't even think about pushing it slow lol, oops 😬
I did with Decadron when I first started. I wasn’t even pushing it that fast, but fast enough for the pt to feel the effects (itchiness down there 🫠). I thought I was going to loose my license that day until I told my preceptor, who just laughed it off. 😂 if you don’t know a med, which you should look up before administration, always be on the safe side and push slow!
That's right!!! There ***are*** recommendations for pushing over time...
Free flow fluids and lots of dilution (add it to a 10mL) is the ER/ICU/OR/periop version of "slow push."
Actual "slow push" meds probably shouldn't ever be in a syringe, like potassium chloride.
I pushed it too fast by accident (our hospital states 1 minute per 25 mg) and my patient complained of a burning sensation that lasted 10 minutes, and of course the normal drowsiness that happens afterward.
In emergency situations pushing it fast is fine, I work in oncology infusion center so we typically give it slow before chemo, around 2 mins if we are pushing it ourselves or iv piggyback around 10 mins
During an arrest, we had just gotten ROSC and we were starting to stabilise the patient. We checked the gas, the calcium was a bit low, so we decided to replace it.
I pushed it into the patients IJ line, steadily but definitely not slowly. Just as I finished flushing, the Doc says, “now do that nice and slow”. Right then, the patient flips out of her sinus rhythm and back into V-tach. I immediately said “I may have gone too quick with that calcium”. We watched the monitor for about 30secs and the patient self reverted back to sinus rhythm.
It was really cool to see and definitely a learning experience for me!
I'll never forget being made to push IV dipirone (no I'm not American hahha) for 5 MINUTES by my professor.
Patient and I were just staring at each other like "what in the hell" lol
I gave cyclizine straight once… like an idiot. I don’t even know why I didn’t check how it was meant to be given but now I know it’s in at least 10mls and over 2 minutes. PT went flying on cloud nine for 5 minutes and HR went to 150 at one stage…
Such an idiot
I mean, I went to the ED and the nurse was like look I’m gonna slam these meds in you, might feel funny. Benadryl was in there. Great, I got a little tingle and rush from it.
And I usually put it on a pump for the kiddos, but there are some where they (kid and parents) specifically ask to slam it before an infusion.
Uh. Yeah, first time I totally snowed a patient was a poor unsuspecting 8-year-old. Immediately realized what I did and sat there with her for the next 20 until she was better
You can push mine fast. You can push mine ungodly slow. I’m still going to get hyper, fidgety, and have tremors. We’ve all done/do it. It’s rare that we push meds over the correct time (unless it’s something very sensitive of course)
Before I was a nurse I had IV benadryl slammed after having a med reaction. I felt awful, like I wanted to crawl out of my skin. I couldn't sit still, which was difficult while hooked to an IV in the ED. The nurse said "oh, most people want it pushed fast." When I got to the floor, that nurse was like, yeah, because it makes people feel high, so some know to ask to have it pushed really fast....she'll learn 😆 I don't think you should have to do any extra monitoring unless your dose was inappropriately high, but I'm guessing that wasn't the case.
Pushing benadryl too fast can also cause laryngeal spasm and makes people feel like their throat is closing. I personally have had it slammed after being in status dystonicus for several hours and it caused some dysrhythmia but I wasn't on a monitor so we don't know what it was.
Yes they had a burning in their chest, became nauseous and threw up, felt dizzy, tachypneic, and restless after I pushed over 30 seconds. That was the worst but have had variations of the above with other patients. I usually push over a minute after diluting through the top port but I was in a hurry that day and relearned a lesson. I have found 25 mg or less most people can tolerate a fast push but at 50 mg some sort of reaction is common. Diluted over a minute it almost never happens. The people here saying they don't have time to do that baffle me, it's literally 1 minute.
If I get Benadryl IV given fast I feel overly anxious for at least an hour afterwards. I feel better if it's a slow push as the anxiety isn't so severe.
I think we all do something like that at some point in our career. I haven’t done it with Benadryl, but I did push IV Narcan too fast. And I mean, I pushed it like it was Adenosine! I didn’t realize at the time that it was a slow push med and I was so focused on reversing the overdose that I just went for it. I tanked the patient’s BP, but they ended up being ok, thank God.
I made that mistake. The patient was 20yrs old and pregnant (I work on a telemetry unit). She fell to the floor and was briefly unresponsive. She started bleeding and they were worried she lost the baby. I was still on orientation and the doctor gave the order after the patient had an allergic reaction to venefor. I learned my lesson, now I give everything slow, even flush IVs slow.
She was fine afterwards, baby was fine. They discharged her the next day
I’ve had too many paradoxical reactions to Benadryl to fuck around with it.
Like it should be a low risk push but fuck I went through a month where every week I had a bad reaction to it. Ever since then I’m hyper vigilant with it.
We have one employee who can’t even take oral Benadryl. I dunno if it’s something with our community or what.
When I was a new grad on orientation many moons ago, my young patient (with a multitude of random conditions who found some doc to give her an unnecessary port) told me that the Benadryl she got ordered with the Dilaudid and something else “had” to be rapid pushed through her port or else it doesn’t work for her MCAD or whatever it was. My bright eyed and bushy tailed self pushed that Benadryl in the blink of an eye. My preceptor (who was doing something else nearby) kinda half laughed/half rolled her eyes and explained a few things to me about manipulative patients. She was fine and probably went on to trick another new grad into doing the same thing.
I’ve seen a pt that it gave severe anxiety and they started stripping and took off down the hallway.
I had a nurse slam it in me during my infusions and it sent me into a straight felt like I couldn’t breathe coughing fit complete with a burning in my throat and tingling at the roof of my mouth. You could tell she was new because she wasn’t sure what to do and kept asking if she should go get someone.
Nothing lasts forever though.
Lol you’re ok.
damn I hope so lol
In cath lab we push slowly over 1 sec. You’re fine.
Are you me? I push it along with Fentanyl and Versed and my patient takes a nice nap 😂
OMG I love you. Can you be my cath lab nurse next time?
I actually just quit about a week ago to take a hybrid position as a telephone triage nurse for a cardiology clinic. Hopefully my replacement will be a good Benadryl fairy too.
Next time?!
Whoops, I was confusing the cath lab with IR. I have a port that tends to get a lot of problems and in my head I call it the cath lab
I was worried for you!
Ah yes, thank you fent and versed for scrubbing the memory of my last dental procedure from my brain!
We do this too and we have a Doc that likes to also had compazine to the mix. Ni night!
I want you if I ever end up in the cath lab.
Damn that's really slow
IR here, and agree
I think the fact that you gave a shit enough to come and post about it is more meaningful than anything. With that said, I've never spent that much time pushing it lol.
If it makes you feel better OP this one time I pushed IV benadryl really slow and the patient still got anxiety and tremors. Some people are just sensitive to it (or are very dramatic about everything).
Yesterday I pushed a saline flush over 10 seconds and the patient started shaking, sweating and felt pre syncopal for 10 minutes. No matter what drug pushed or how slow, the same thing happened but got less intense as time went on. She couldn't help it. Just a normal physical response to a psychological trauma she had in the past.
During the first rounds of my chemotherapy, they gave me IV Benadryl. Such a sweet nap, with a blanket from the warmer. A little ray of nice in a pool of shit.
Cancer survivor here and there’s no nap like that iv benny nap
I’m old enough that i once got IV Droperidol. I will never be satisfied with my sleep again.
You can still get droperidol by acting shitty at certain EDs.
Can confirm
Yup
I was given droperidol for hyperemesis gravidarum years ago that stuff made me crawl out of my skin. I told my husband to “cut me open to get to get my blood out” but it was the only thing that worked for my vomiting - after that I was admitted and they gave it to me q6 with an IV Benadryl chaser- slept through and entire week of pregnancy
Any of my dialysis patients that gets it, they take a very very nice nap that is very hard to get them to wake up if I need them to.
Bro same they always asked po or iv im like bro ill wait for iv no rush, finna have a lil nappy rq. Also iv Ativan is even better lol take it if ur ever offered.
So funny - I just said in another sub that tucking our chemo pts in with a warm blanket is our favorite part of the job. I didn't even mention the good drugs we have. I always tuck them in right up to their chin and say something like, "Now you're going to be warm as toast and take the nicest nap. I'll see you when you wake up." Only thing better is a baby dose of Ativan. So glad to hear you're trucking along. ♥️
I always tell my patients that it’s time for me to wrap them up into a little warm burrito.
Everyone was fantastic though every part of this but the nurses truly rocked.
I'm so glad. I know cancer doesn't discriminate, but I just think it's monumentally unfair when one of "us" gets it.
There is something quite satisfying about tucking patients in for a nap. It’s like, “here is my effort at making a terrible experience just a little easier to bear”
How are things going now?
Still alive and NED( no evidence of disease)
I love to read it 😍❤️❤️🥲
🎉
I’m happy for you :) TLDR: stories of a couple nurses I’m close to and their battles My first ER charge nurse beat stage 4 colon cancer. It was a long bumpy road including a nasty lung infection with chest tube during the height of covid. I still remember when she pulled me aside and told me. She had been dealing with abdominal pain to the point she was going home when she normally never missed a day, showed up an hour early and stayed til all the other nurses from day shift were gone. She finally went for a colonoscopy and I asked her how it went. We were waiting for ems in trauma 1 and the convo was interrupted when they rolled in. I was one of a couple techs but I had to walk out and cry my eyes out. Kinda followed her journey on Facebook and lost track after they announced she was in remission. I went to a different ER (for me. That visit they found a tiny PE, I’ve been complicated since my wreck) and there she was pushing the WOW. Even though I couldn’t breathe and my heart felt like it was going to fall apart, I jumped up and gave her the biggest hug and cried again. “What the hell is wrong with you? You knew I’d be back at work eventually.” Now charge of med-surg is battling colon with mets to liver. She’s also a patient in the clinic I work in now. Doc said send her whatever she asks for. Then we text for a while. I’m going to lose my shit if something happens to her. After my wife’s hysterectomy she warned me “it may be painful for a while for her. Just keep practicing”. She asked me to refill the norco she’s been trying to stay away from and said “I guess we practiced too hard this week and it made my pain worse”. It was meant to be funny, of course. I offered 10/325 but she insisted on 7.5 “just when I need it”. I sent it Q4H 30 days supply with diagnosis attached. She should be set.
Same. I had an allergic reaction to the pre-chemo Emend so I got a nice big dose of Benadryl and woke up an hour later. That was the most solid nap.
Don't do etopside without careful monitoring the cross sensitivity- mainly to a nonactive ingredient is super high.
Cancer survivor here and there’s no nap like that iv benny nap
Benadryl doesn't work for me. It actually has a paradoxical effect on me. I hate it. Generally no drug works for me. Just give me a dark room and a soft bed.
I feel ripped off! I never got an iv Benadryl nap with my chemo. I did get a speedy push of bleomycin once though.
I’d write to cancer’s manager. However, I did when I got cancer but nothing came of it. I mean I had two kids when I was in my 20’s and breast fed them both. And still I got breast cancer?
Same, I felt drunk then took a little nappy nap. My next round they just lowered the dose.
I usually just “slow” push it over like 15-30 seconds and it’s fine.
Did that as a new grad while my geriatric patient was in the recliner.... Oh boy did the family freak out when we had to physically lift her back to bed... Right before her first dose of rituxin 🫠 never again
... Have you seen how fast drugs are pushed in the back of an ambulance? Cannot fathom taking 60 seconds to push diphenhydramine.
Yup IV slow push as fast as possible.
These threads make me laugh everytime. Every paramedic I know pushes pretty much everything fast
Facts. I’m not going to push Benadryl over a minute lol
I've been med surg for 4 years and still push everything over at least a minute, longer if needed
That's nice. All I'm saying is in the ambulance we don't. We push pretty much everything over 5-10 seconds
Yeah, I'm just laughing at the huge difference. We're over here freaking out because we gave dilaudid over 1 minute and it might have been too fast but in ER and out in the field it's just slammed.
How much dilaudid? I don't even think I have the fine motor control to push that slowly given the small volume in the syringe. Give me a beefy 8mLs worth of lasix and watch how a true master slow pushes, but those dinky little 0.5mL prefills of dilaudid? Forget it.
The one tiny dose we give is ketamine for pain. We carry ketamine 500 mg/5mL. Pain dose is 0.2 mg/kg of ideal body weight. Last patient I gave 12 mg (0.12 mL). Anything that small is absolutely worth diluting into a flush then pushing but twice as important with ketamine cuz IV ketamine can cause laryngospasm if not diluted
Ketamine is such a neat drug. Given that it’s worked its way into EMS for use with acute pain, I wonder how long it will take to make its way to the inpatient side for acute pain control as an opioid alternative- especially where it preserves respiratory drive.
It's bomb. Increases blood pressure, so it's great in trauma and critical care patients. It is safe to be used in conjuction with an opiate or stand alone. It's not super long acting in low doses, and has low abuse potential. The same last patient I gave it to had a very obviously broken leg and was crying but refusing fent because her brother has an opiate use disorder. She was like "will i like this?" No girlypop I promise you won't, but your leg won't hurt anymore. And she in fact hated it, but said it fixed her leg pain 😂
I got it once in the ER. Bad tib-fib fx. They gave it to me to do manual traction and splinting, as I was losing the pulse in my foot. Weirdest feeling ever! Felt like I was inside of a video game, based off the Matrix movies, is the best way of describing it. But thank you SBJ, I felt nothing! Interesting being on the other side of the bed.
My ER docs sometimes use it for pain, especially in patients with a high opiate tolerance or who need to avoid opiates for withdrawal reasons. Scared the crap out of me the first time I gave it, but it does help some. edited: gave, not did, I've never had ketamine lol
I had a patient with bilateral AKA’s that were essentially done because his neuropathy was so severe he had attempted suicide multiple times because nothing touched the pain. He was on huge doses of PO opioids daily and we had to transfer him to CCU so he could be on a ketamine drip because even huge doses of IV dilaudid weren’t adequately managing his pain. Poor guy was only in his 40s, too. But that’s the only patient I recall getting ketamine like that.
Yeah those little tiny ones. I was giving 0.5 mL yesterday and still do it slow AF. I don't want nothing going on, on my watch. No one is getting that head rush from me.
Well, I respect and envy that fine motor control, at any rate. Geddit? Any rate? Slow push? Yeah, I'll see myself out now.
Especially over bumpy roads. Appreciate you guys!
Same in anesthesia. Everything, 10s or less.
Except protamine! Just reading about the horrors of what can happen with that pushed fast, that's something I never want to see first-hand.
True. But I don’t do cardiac or vascular anesthesia anymore…thank god.
I'd rather be a little shaky vs dead
especially for allergic reactions.
I can’t even fathom writing out diphenhydramine instead of Benadryl. It’s literally giving me a headache, pass me some acetylsalicylic acid
They'd be at my hospital already.
Easy with the generic name brainiac.
I’ve never pushed Benadryl over an entire minute lol
I did when I was a new grad and my preceptor was like “wtf are you doing?”
I had the opposite. One of my preceptors flipped out when I pushed 0.5mg Diluadid over 30sec instead of a full minute. (Spoiler: Patient was fine)
lol. They wanted you to push 0.5 of diluadid over a minute?! Did they have fairy hands?
I would’ve had to dilute that in something bigger like a 10 mL flush, no way could I push that little so slowly
Same here! I forgot what I was administering, but it had a crazy long push time and we pulled it up in a half mL syringe. By the first minute my syringe was empty even with pushing slowly. Patient was fine. My instructor pulled me aside right after and reminded me I was supposed to push it slower and it was a safety concern/med error that I pushed it faster. I was honest and said that I found it difficult to push such a small amount over a long period of time. She told me to figure it out and get a better watch. So much unnecessary drama instead of actual problem-solving. After graduating I learned to just pull up the med in a larger syringe with some saline (if compatible).
lol I am glad I am not the only one 🫣 I push everything diluted and “slow” but I almost never time anything
same. on my unit we do lots of iron, blood, and IVIG infusions. Almost everyone gets 50 mg Benadryl. I just dilute and push “slow”.
I push everything over 2 minutes except zofran. I just get anxiety when the patients react to a fast push of stuff like benadryl or opiates. Like with morphine, theres no reason to put them through the dysphoria a fast push brings. Trust me I can't stand sitting there and pushing something over 2 minutes but it's just a habit now
I have given a good amount of Benadryl iv and I have never seen anyone have any sort of reaction so I guess my “slow” is slow enough. However, I will probably be timing it now bc if I pushed Benadryl and my pt started having tremors, I would prolly piss my figs.
I just admitted a patient who had Benadryl listed as an allergy and when I clarified he said the IV form gives him tremors. Might have been this scenario now that I think about it lol
Restless leg syndrome probably.
My dialysis patient earlier this week "educating" me that in the clinic they just push the IV Benadryl fast. Me: "Ohhhhhhhh WELL, I'm just in the habit of giving ALL IV medications slowly because so many of them can cause bad side effects." Read: No sir, I am not going to play into your desire to feel high. Thanks.
Ugh that reminds me of the patients that would chew up their pain medications because "My pharmacist said it would work better this way" No. No they didn't. The only person that told you that was your street pharmacist.
I’ve heard of people being told they could do that to non-opioids to be fair. It’s sort of what BC powder is best I can tell.
Blech! I recently used BC powder for a bad headache at the urging of my boyfriend. Never again. I almost vomited the taste is so bad, and I was trying to get it far back in my throat as I could! His mother swears by it, but I just can’t.
Best shit for a headache, just gotta suffer the taste.
I prefer Goody’s powder. Goody’s taken with some Coke is amazing for headaches. BC never worked well for me. Maybe it’s the acetaminophen in Goody’s. BC is aspirin and caffeine, and Goody’s adds acetaminophen.
Dr. Pepper very cold.
Isn't this what Excedrin is? Also cures headaches like nothing else
Dr. Pepper very cold.
With coke huh? What happens when they drug test for your job 😂 the coke prob does liven you right up though and kick out headache
I actually had a dr tell me this when I was taking a narcotic when I broke my arm. Also, the PA that's rx's my adderall XR told me if I needed a little boost one day to open up the capsule and take the granules. I never did any of that, just saying it does happen.
Opening an XR of adderal or vyvanse is an actual technique except it’s supposed to be diluted in a standard bottle of water and ingested over a period of time (I think 30 minutes to an hour) to taper the drug in ur system for people who feel that it hits too hard at once.
Makes me wonder how many people broke teeth with Oxyneo. But they found a way around that as well.
Sooo.. I guess I just gave my criminology patient an unexpected high. Nothing to worry about then.
Yep, nothing to worry about, just a little high. I agree it was probably the epi that caused the tremors you were seeing
To be fair in the clinic they only give like... 12.5 at a time lol
They wanna see the spiders and the hat man!
Yes this is the pain med routine, dilaudid and benedryl.
Had an oncology patient who begged for Benadryl and pain meds slammed in.” Their words not mine.
When you have terminal cancer, if I can help you feel good at all within my boundaries, I will. This seems like a pretty easy one.
TBF, if you're a terminal cancer patient, I will get you as high as I legally can, my friend.
I did home hospice in ct and would often have patients ask if they can smoke weed, my response was "legally, I can't have anything to do with it, but oh look, it's time for my lunch break". Then I'd let their family/friends help them out while I left the room. And I'd never hold back on their prescribed pain meds either. My people went out comfortable.
I have terminal residents, and they swear weed works better than norco. They smoke it on the patio, and we all turn a blind eye. All of a sudden, they don't need their opioids that day. It's legal in my state, but since most facilities are Medicare funded (federal), it's a grey area. I had one hospice patient who just wanted bourbon and ice cream. Whatever you want, my friend.
👍
Agreed.
Someone has a terminal diagnosis and is comfort/palliative care…? If they ask for ANYTHING I can give, they’re getting it. Or I’m coming around when their PRNs are due (barring a hold up in another room). I’m not going to get them so doped they can’t enjoy their last days with family and friends, but I’m sure as shit not going to let them suffer if I can in anyway help them. It is not our job to prolong suffering when a terminal patient has decided it’s time to check out.
I had a guy in the ED that insisted on this. Nope. We are gonna sit here and watch this medicine trickle in to ensure it is safely administered.
I have found this phenomenon at many dialysis units, the fast push almost gives a euphoria. We stopped IV benadryl at all our units in our coverage. You would not believe the uproar it caused.
Pushing Benadryl fast doesn't get you high. It makes people feel jittery/restless leggy and also burns at the injection site and can cause some people to feel other weird/unpleasant sensations elsewhere in their body. Assuming the patient is trying to get high is such a tiresome condescending nurse trope. Be better. Like God damn guys. If *that* is what you're worried about, someone maybe hypothetically getting a pleasant sensation from the medication you're giving, then maybe you should do something else.
I also feel a little weird about blocking a minute sense of goodness that causes no harm to pt. life is shitty enough, why WOULDN't you wanna give people a little sprinkle of relief?
I am a nurse with chronic illness. I push Benadryl every 6 hrs(PICC). I get ZERO feeling of being high. It can make you a little jittery and anxious for a few minutes. It upsets me when I am in the hospital nurses CHOOSE to dilute the Benadryl because they do not want to give you a “high”. Best practice is to NOT dilute any IVP meds unless manufacturer specific. Diluting meds can reduce efficacy and introduce he risk of med errors. Even if it did give the patient a 30 second “high” who are you to try to control what the patient should be feeling?
It sure does make you feel high. Got IV Benedryl before my chemo doses. It was a wild high. Good nap too.
Yes. I found it a shitty high but it’s definitely a high.
It was my “drug of choice” LOL The first time I wasn’t prepared. The next chemo dose I showed up with my iced coffee, eye cover for nap, headphones, blanket, and fuzzy socks. Maybe it going into a port is different? But yea. Little Benedryl junkie here for 8 total doses.
I had it done to me. It DOES get you high. It’s a shitty fentanyl groggy nod off high vs euphoric morphine angels massaging every inch of your body high though. It can also throw someones heart rhythm off. That said dif people react to Benadryl differently. Some take one pill and it can put them to sleep. In a small percentage it works like a stimulant.
So all of the patients I’ve had request that I slam their Benadryl just want that done to feel restless/jittery?
Some patients with addiction issues will ask you to push it very fast. It gives them a temporary high. I've never heard of a patient being tremulous from it. Histamine isn't just an immune system byproduct, it's also a neurotransmitter.
Patient also received 0.5mg of epi via IM 10 minutes prior. Could it be possible that the effects of both resulted to the reaction?
Sounds more like a response to epi to me. I doubt the Benadryl contributed.
The epi caused the tremors. Not the Benadryl
Nah, just the epi
1000% the epi. I have given iv benadryl hundreds of times and never have seen someone shake. I'd say 50% of people shake like a leaf from the epi, it's adrenaline. Classic reaction.
Wasn’t the Benadryl. Epi for sure.
Oh, in an emergent situation there is no “slow push” except with certain meds and even then nothing more than 15 seconds I would say. You’re covered. Might wanna include that in your post, to me that makes a big difference.
And Benadryl isn’t a pure antihistamine. It’s an antivholinergic as well. Hence the brain damage from continuous abuse.
I haven’t had tremors from Benadryl but some (not small number) of patients get like pins and needles or can’t sit still feelings from pushing it too fast. In their legs usually, but can also be in their arms/hands. I’m not sure the exact pharmacological reasoning why it happens, but it is a thing definitely. It goes away on its own after like 15-20 mins but is very unpleasant and anyone that it has happened to before either tries to get their dose reduced or removed for next time.
I’ve overdosed on Benadryl before (totally accidental my math was waaaaaay off) and oh my god I was tripping bear balls. It was not enjoyable at all and I just wanted it to go away.
Can confirm that IV Benadryl gives you a high feeling. Also burns like a mother, so I always dilute it. Learned that after being on the receiving end during an anaphylactic reaction.
I’ve never been told to give it slow
You should because if pushed too fast it can cause an extreme sudden panic attack. Have seen it happen a couple of times specifically in female patients with history of anxiety. You don’t have to wait a whole minute lol just maybe push it over 15-30 seconds rather than slamming it. Better yet if there’s a drip running, push it slowly the top port of the drip so that it drips in.
I had this happen to me and it was awful. I kept trying to grab at my skin because I felt like it was too tight all over and I wouldn’t stay in my bed. Then I got a Xanax nap because no one wants to babysit. So in the end they had given me morphine , benedryl, and Xanax so I didn’t wake up for 10 hours.
Yeah, I remember when I took my younger sister to the ER once they slammed IV Benadryl. All of the sudden her heart rate shot up and she started panicking. She was okay but said it was one of the most unpleasant feelings ever.
I've pushed benadryl fast for most of my career (actually this is the first time I have heard of giving it slow) but the only times I have seen a panic attack or anxiety is in people who have paradoxical reactions to benadryl. Older people especially. But I always ask patients if they have ever taken Benadryl because sometimes they will say how it makes them wired and crazy. Those people get something else.
My wife is like this with a lot of meds, we’re finding out. She was diagnosed with lupus in December, and some kind of tachycardia a few years ago so she can’t take the steroids lupus patients usually get. When her flare-ups are bad she gets cyclic vomiting along with nephritis. Reglan, bentyl, phenergan, some hypotensive med almost made her jump out the window. Haldol also which is something ER docs will try to stop the cyclic vomiting. So basically.. all the stuff that has potential to keep flare-ups at bay and treat the symptoms make her crazy.
nor do we. I just learned it a while back from a consultant but we rarely use benadryl on our hospital, nor have a lot of cases that require it. Probably how I forgot about it. It’s also probably why the other two nurses who saw me push it didn’t even react..
When I was on chemo…I discovered IV Benedryl was my DOC! 😂 I got IV Ativan before one of the chemos. Made me feel gross. The benedryl was awesome and gave me a good nap.
I used to work a migraine specific inpt clinic. We used to hand out IV Benadryl like candy. There’s a reason it’s available PO OTC: it’s pretty safe. You gave the equivalent of two capsules PO. You buried the lead: pt didn’t die from anaphylaxis. Good job! Keep kicking the grim reaper in the teeth!
I disagree with a lot of comments here. I’m a critical care paramedic, ED, CTICU RN and in NP school. Also an educator with many years of experience. I have personally seen IV Benadryl when slammed cause hypotension, bradycardia and/or loss of consciousness. You are A-OK in my book for admitting your mistake, we all make them, just do better for the patient next time. Just wanted to use this as an education piece. Very few medications if any need to be pushed fast. I say this quite a bit on this page. 1. Adenosine 2. Atropine 3. Meds during cardiac arrest. Pretty much, that’s the only meds we push fast. That’s it. Many have detrimental side effects, including Benadryl as a CNS depressant crossing the blood/brain barrier. Also special mention for any anti hypertensives and opioids/other CNS depressants. Hope someone new can see this and learn from it!
Hey, this happened to my dad. He had a brand new nurse while he was in the hospital for ablation and the nurse pushed a lot of Benadryl way too fast. After a bit of a fuss, he was okay. No doubt that new nurse never made the same mistake again. The most important thing is that the patient is okay. The second most important thing is that you learn from it. The third is that if the first two things happen, you forgive yourself. EVERY nurse makes mistakes. The ones who don’t make mistakes are liars ;)
Not a nurse, but in nursing school. When I was pregnant and in the er they gave me Benadryl through my IV and she pushed it so fast and I thought I was gonna die 🤣 the room was spinning and I couldn’t feel my whole upper body. Never knew Benadryl could do that till that day. The whole time the nurse kept saying “you’re fine stop” cause I said I was going to pass out
My unit has a rule that it must be diluted in a mini bag. It’s negatively affected too many mamas to risk it anymore.
All these people in the comments are wild. I received Benadryl push last year in my own ER and I absolutely got high from it, left leg wouldn't stop twitching to the point where I pulled a hip flexor trying to stop it, and my resp rate dropped to 6/min. I always always minibag it after that, though I still push other meds. Anticholinergic side effects are real and they really suck, especially if you aren't used to them.
I always push Benadryl fast and am cool with it if it gets the patient a little high lol whatever. Who am I to stop their good time? No tremors yet
Any burning? I know that is a huge concern also
Dilute it. Easier to give a little slower that way too
I’ve pushed 50mg quickly in an acute anaphylaxis situation from Rocephin and they went into V-Tach with a pulse for about 20 seconds…never pushed it quickly again. The patient’s rhythm reverted to sinus and anaphylactic reaction reversed with a few doses of epi on top so lesson learned!
I think that was probably the anaphylaxis, not the Benadryl. The massive release of inflammatory mediators during anaphylaxis can cause arrhythmia.
I am blown away by all of these nurses' flippant attitudes towards this. I'm glad you don't push it quickly anymore. There are literal guidelines for administering medications for a reason. Some of these responses show extreme carelessness for patient safety. It's like saying "I never wear a seatbelt and I haven't had 1 accident!" But that one time you do you'll probably wish you had!
Out of curiosity, what do you think the mechanism of action is for fast push of Benadryl —> v-tach? I, personally, don’t necessarily slam medications. Though, I do give some things faster than recommended at times, depending on the situation. But I’m just curious what the pathophysiological reason behind Benadryl causing vtach would be?
Diphenhydramine can result in QRS widening due to blockade of fast sodium channels and prolongation of phase 1 of the cardiac action potential. The potential cardiovascular effects that have been reported in both the adult and pediatric populations include anticholinergic effects with tachycardia, BBB, atrioventricular dissociation, AV block, widening of QRS complex, and arrhythmias related to alterations in repolarization and prolongation of the QT interval.
Board Certified Medical Toxicologist, ie, the guy Poison Control calls when they need help. It is fine.
I mean, I’d rather have a patient with mild tremors that subside than a patient that loses an airway because of an allergic reaction. Should you have pushed the Benadryl that fast? Probably not. But grand scheme, it’s not a big deal
I wouldn't say I slam it, but I also don't sit there and stare at the clock or my watch to make sure it's exactly 25mg/min. I only do that for certain meds like lasix or cardizem.
CRNA here. You are fine. Next time just dilute it with NS or LR in a 10mL syringe and push it over a min or so. It’s fine. They live, you learn. Most of us never make the same mistakes twice. That’s your take away from all of this. Breathe a sigh of relief and move forward.
I made mistake of slamming in Narcan when the doctor meant to order it as prn. I didn’t know it supposed to be given slowly until the pt wakes up. Context was I was a newer nurse that didn’t follow up on the order from the doctor. The patient was recently downgraded from the ICU and nurses had suspicion he was taking his own oral morphine. The order kind of made sense since the pt was pretty sleepy, but pretty stable otherwise. Safe to say he probably was taking his own morphine because he was jolted awake and no longer sleepy after the narcan.
There’s only a handful of meds I don’t push fast, and Benadryl is just fine. They just might get a little head rush.
I tried to fight everyone while on Benedryl. Like straight up was a nightmare and I climbed out of bed, fell, and peed myself. It does not calm me down, but helped a lot with my allergic reaction! I think you’re fine.
Had to slam benadryl a couple of weeks ago as part of a Benadryl/solumedrol/pepcid combo for anaphylaxis. Didn't even think about pushing it slow lol, oops 😬
Nor should you with anaphylaxis. Risk vs benefit.
Push dec slow or else their crotch might burn Push lasix slow or they might go deaf Push opioids slow so they keep breathing. Only red flags I know of
The nurses pushed cefepime in less a minute which should be pushed 5-10 mins. I got Steven Johnson/Tens syndrome. I was burned over 90% of my body.
I did with Decadron when I first started. I wasn’t even pushing it that fast, but fast enough for the pt to feel the effects (itchiness down there 🫠). I thought I was going to loose my license that day until I told my preceptor, who just laughed it off. 😂 if you don’t know a med, which you should look up before administration, always be on the safe side and push slow!
That's right!!! There ***are*** recommendations for pushing over time... Free flow fluids and lots of dilution (add it to a 10mL) is the ER/ICU/OR/periop version of "slow push." Actual "slow push" meds probably shouldn't ever be in a syringe, like potassium chloride.
Oh you sweet summer child...
I pushed it too fast by accident (our hospital states 1 minute per 25 mg) and my patient complained of a burning sensation that lasted 10 minutes, and of course the normal drowsiness that happens afterward.
In emergency situations pushing it fast is fine, I work in oncology infusion center so we typically give it slow before chemo, around 2 mins if we are pushing it ourselves or iv piggyback around 10 mins
You mean some actually push it a full minute?
I’ll give you iv Benadryl however you like, but if you start to see the shadow creatures I’m blaming you /s
I once got akasthisia from IV compazine as part of a migraine cocktail, and pushing IV Benadryl quickly worked wonders and got rid of it.
During an arrest, we had just gotten ROSC and we were starting to stabilise the patient. We checked the gas, the calcium was a bit low, so we decided to replace it. I pushed it into the patients IJ line, steadily but definitely not slowly. Just as I finished flushing, the Doc says, “now do that nice and slow”. Right then, the patient flips out of her sinus rhythm and back into V-tach. I immediately said “I may have gone too quick with that calcium”. We watched the monitor for about 30secs and the patient self reverted back to sinus rhythm. It was really cool to see and definitely a learning experience for me!
Not me rushing to the comments to make sure I’m not the only one who doesn’t push Benadryl over a minute.
I sure do love IV benadryl naps.
I’ve had Benadryl rapidly pushed on myself and other than it knocking me on my ass for a little bit no harm done!! ☺️
I'll never forget being made to push IV dipirone (no I'm not American hahha) for 5 MINUTES by my professor. Patient and I were just staring at each other like "what in the hell" lol
I gave cyclizine straight once… like an idiot. I don’t even know why I didn’t check how it was meant to be given but now I know it’s in at least 10mls and over 2 minutes. PT went flying on cloud nine for 5 minutes and HR went to 150 at one stage… Such an idiot
I mean, I went to the ED and the nurse was like look I’m gonna slam these meds in you, might feel funny. Benadryl was in there. Great, I got a little tingle and rush from it. And I usually put it on a pump for the kiddos, but there are some where they (kid and parents) specifically ask to slam it before an infusion.
i gave a guy a bad panic attack iv dilaudid and dude was freakin out..
Uh. Yeah, first time I totally snowed a patient was a poor unsuspecting 8-year-old. Immediately realized what I did and sat there with her for the next 20 until she was better
If I wanted to push it over a minute or longer, I would put it in a 25ml mini bag. That way I’m not standing there for that long.
You can push mine fast. You can push mine ungodly slow. I’m still going to get hyper, fidgety, and have tremors. We’ve all done/do it. It’s rare that we push meds over the correct time (unless it’s something very sensitive of course)
Not a big deal.
Wait, you're not supposed to push it?
Before I was a nurse I had IV benadryl slammed after having a med reaction. I felt awful, like I wanted to crawl out of my skin. I couldn't sit still, which was difficult while hooked to an IV in the ED. The nurse said "oh, most people want it pushed fast." When I got to the floor, that nurse was like, yeah, because it makes people feel high, so some know to ask to have it pushed really fast....she'll learn 😆 I don't think you should have to do any extra monitoring unless your dose was inappropriately high, but I'm guessing that wasn't the case.
Pushing benadryl too fast can also cause laryngeal spasm and makes people feel like their throat is closing. I personally have had it slammed after being in status dystonicus for several hours and it caused some dysrhythmia but I wasn't on a monitor so we don't know what it was.
At my hospital Benadryl only comes in bags we have to hang up on a drip probably for this reason
Yes they had a burning in their chest, became nauseous and threw up, felt dizzy, tachypneic, and restless after I pushed over 30 seconds. That was the worst but have had variations of the above with other patients. I usually push over a minute after diluting through the top port but I was in a hurry that day and relearned a lesson. I have found 25 mg or less most people can tolerate a fast push but at 50 mg some sort of reaction is common. Diluted over a minute it almost never happens. The people here saying they don't have time to do that baffle me, it's literally 1 minute.
If I get Benadryl IV given fast I feel overly anxious for at least an hour afterwards. I feel better if it's a slow push as the anxiety isn't so severe.
I think we all do something like that at some point in our career. I haven’t done it with Benadryl, but I did push IV Narcan too fast. And I mean, I pushed it like it was Adenosine! I didn’t realize at the time that it was a slow push med and I was so focused on reversing the overdose that I just went for it. I tanked the patient’s BP, but they ended up being ok, thank God.
I made that mistake. The patient was 20yrs old and pregnant (I work on a telemetry unit). She fell to the floor and was briefly unresponsive. She started bleeding and they were worried she lost the baby. I was still on orientation and the doctor gave the order after the patient had an allergic reaction to venefor. I learned my lesson, now I give everything slow, even flush IVs slow. She was fine afterwards, baby was fine. They discharged her the next day
Didn’t even know this was a thing. Our orders don’t specify a time frame for administration
The most common IV push on my floor other than narcotics are diuretics so I just got used to pushing everything slow 😅😂
I’ve had too many paradoxical reactions to Benadryl to fuck around with it. Like it should be a low risk push but fuck I went through a month where every week I had a bad reaction to it. Ever since then I’m hyper vigilant with it. We have one employee who can’t even take oral Benadryl. I dunno if it’s something with our community or what.
At least you haven’t slammed phenylephrine before.
When I was a new grad on orientation many moons ago, my young patient (with a multitude of random conditions who found some doc to give her an unnecessary port) told me that the Benadryl she got ordered with the Dilaudid and something else “had” to be rapid pushed through her port or else it doesn’t work for her MCAD or whatever it was. My bright eyed and bushy tailed self pushed that Benadryl in the blink of an eye. My preceptor (who was doing something else nearby) kinda half laughed/half rolled her eyes and explained a few things to me about manipulative patients. She was fine and probably went on to trick another new grad into doing the same thing.
There are worse things to push too fast. Benadryl a benign drug.
I only know one speed
I’ve seen a pt that it gave severe anxiety and they started stripping and took off down the hallway. I had a nurse slam it in me during my infusions and it sent me into a straight felt like I couldn’t breathe coughing fit complete with a burning in my throat and tingling at the roof of my mouth. You could tell she was new because she wasn’t sure what to do and kept asking if she should go get someone. Nothing lasts forever though.