Dangers of Phenergan || EMS Pharmacology
“Find a big, healthy vein. Double check the patency of the line.” These are tips given to students while learning how to place IVs and they are ESPECIALLY emphasized when giving a dextrose product. The truth is dextrose products are not the only medications that can cause catastrophic side effects when an IV line infiltrates.
Promethazine (brand name phenergan) can cause severe burning and irritation at the site. There are extreme cases where necrosis could occur and have life-altering consequences as a result (gangrene, amputations, etc.).
So what can we, as EMS providers, do to reduce the chances of these possible complications? Select a healthy vein and double check the patency by flushing the line & looking for signs of infiltration, redness or tenderness. If your protocol allows, you can also dilute the medication in a small NS bag or even a 10 - 20 mL flush. If you are able, you may choose to start off at a lower dosage.
BUT WAIT…… the MOST important thing we can always is to listen to your patient. If the patient begins to complain of pain or extreme burning, stop the administration immediately.
If you are interested, clink the link below for my full Promethazine breakdown on YouTube!
https://youtu.be/-yxAOijsK6M