RE: subq MS in LTC

[Laurie Hill]

Are you talking about giving prn morphine into the subcut. tissues via an indwelling needle?  I know we can give morphine subq but if you left a needle in the area I imagine absorption would change over time….as does anything else given subq in the same area…insulin, heparin, etc….several possibilities could happen: no absorption of morphine, a little absorption or multiple doses absorbed all at once. If we are talking about end of life comfort measures I would think you’d want to be somewhat consistent in knowing what you’re giving and how much is working to relieve the pain. My understanding (which is very minimal) of the indwelling sub q catheter that’s use is for subq narcotic administration for the terminally ill is that it’s more like a ‘sprayer’ on the end versus a needle. So I could see that with a spraying affect it would absorb more evenly and at a more consistent rate, also would not damage the tissue as much/as fast. I would be curious what other people have to say that have actually seen/worked with this (again, I haven’t). Laurie Hill RN Radiology/PICC nurse         From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED] Sent: Wednesday, April 26, 2006 1:43 PM To: [EMAIL PROTECTED] Subject: subq MS in LTC   Has anyone heard of placing a subq needle and giving morphine by push, capping off the extension tubing and administering it either routinely or prn? This situation came up in a LTC facility where the local pharmacy states that a hospice company is doing that and not using a PCA pump. It sounds great because nurses in LTC don't use a PCA pump very often and they don't feel comfortable with one, whereas just pushing the MS through an indwelling needle saves the resident many sticks. I am interested to see if other nurses around the country have heard of this practice.   Thanks, Diane Jiles, RN-CRNI