Cosig IV titrate (Fentanyl)
also
cosig IV perp (Insulin)
The only part I can help you with is titrate. That would mean they’re going to increase the dosage of the Fentanyl over a set amount of time.
I have no idea what cosig or perp means. Is this handwritten or typed?
It’s typed. I’ve seen it at my other clinical site too but I’m not a nursing student so I have no clue what they’re trying to say. Unfortunately I have to include all drugs in my case study, not just the respiratory ones.
Might ‘cosig’ be short for ‘co-sign?’ As in a drug requiring a second signature for a nurse to administer.
I can definitely see that for the Fentanyl buy why would insulin need that?
Dunno. But a little Googling search indicates that some hospitals require that for IV insulin. Just to double check that the rate is set correctly.
Ooohhh. Ok, that makes sense. Thank you.
Cosig is the name of a blend of sulfamethoxazole and trimethoprim made by Sigma; it’s also made by Hoffmann-La Roche under the name Bactrim. It’s a very potent antibacterial, but why it would be blended with painkillers or insulin is beyond me, so very likely the others are right and it’s short for “co-signature.”
Perp might stand for perpetual.
The poor guy had an infection, which caused pain? He also happened to be a diabetic…
It sure seems to me that if any of this is important it ought not to have abbreviations that everybody involved with is just guessing about.
Right? You’d be surprised as how non-standardized medical abbreviations are. It’s actually a big problem that leads to a lot of medication errors. That’s part of what electronic medical records is supposed to fix.
I’m a nurse, but I have no idea what those mean. I don’t do many IVs, because I’m a home health nurse, and that nomenclature wasn’t taught in nursing school. If I were to go work in a hospital, I’d have to ask someone what it meant.
My GUESS is that “cosign” is correct. I do know both of those are medications that many hospitals require 2 RNs to sign off for. Fentanyl because it’s easy to overdose and cause respiratory depression and death, and insulin because it’s easy to overdose on and cause hypoglycemia and death.
Titrate means the dose is either increasing on a time schedule, or the doctor has written a range of doses, the starting dose and then an instruction to “titrate as needed to pain relief” or “pain prevention”. Basically, the nurse sets the dose based on what’s needed without causing breathing to slow down too much.
That’s not a complete prescription or order to the nurse administering it. More details are undoubtedly available elsewhere; that label is just a reminder.
I’m a doctor, neither of those make any sense.
I’ve been a Med-Surg nurse *and those orders are not intelligible to me.
- now in home health
Insulin is often delivered via peripheral IV, isn’t it ? Perp for Peripheral it seems.
it just a reminder, or a “cheat sheet”… helps the crash team if they know what they are disconnecting.
What a remarkably stupid abbreviation if this is the case, saving a whole two characters on the label.
It’s probably truncated by a computer that is ignorant of heuristics. As Whynot noted, it’s not a complete order but likely a pharmacy code.
Co-signing of insulin is quite common on inpatient settings.
IV insulin can go in any available IV, no order is needed to go peripherally vs centrally.
Co-signing a continuous infusion each time you make a change (titrate) is common enough.
Would really need more information, my advice would be talk with someone who works where this is written.