Dumb IVPB question - page 2

Hi Nurses! I was hoping someone could help with a discussion we were having at work yesterday. We were discussing different ways to run in IV meds, specifically IVIG. Sometimes we piggyback things... Read More

  1. by   CritterLover
    Quote from nelliep73
    the reaction thing makes sense, but it doesn't seem like there would be more than a couple of cc's difference that way...the way she was acting it seemed like something much more serious than that, and i was worried that i was doing something wrong. thanks again, all!


    [font="comic sans ms"]then my guess is that this is just how she was taught. as you know, people often have reactions to ivig. the person administering it needs to be knowledgeable and prudent. she probably learned that this was "the way" to do it.

    the first hospital i worked at after nursing school always ran blood on a pump. to not use a pump was considered a med error. the hospital i went to next never used a pump. the blood tubing wouldn't fit in the pump, and the pump functioned in such a way that it would have crushed the rbcs. the next hosptial i went to it was our choice. blood bank distributed both pump and non-pump tubing for use with the blood, you just told the person picking up the blood what type of tubing you wanted. they used to have the type of pump that crushed red cells, but switched, and it is now safe to use a pump to infuse blood. we had one nurse who had been taught at this hospital's ns, and it had been drilled into their heads to never run blood on a pump. she got upset about it every time she saw it. we couldn't convince her it was safe.

    maybe it is the same kind of thing with your coworker? she was taught the "one and only" correct way to infuse ivig, and nothing is going to change her mind?
  2. by   Jesskanurse
    I'm confused....why are they using D5W with the IVIG instead of 0.9 NS anyways? I am in a Critical Care class right now and they said that D5W actually works hypotensively since the dextrose metabolizes so quickly. I dont understand why they are putting a hypotensive solution with a blood prouduct... please help me understand

    ??
  3. by   Alexsys
    Quote from Jesskanurse
    I'm confused....why are they using D5W with the IVIG instead of 0.9 NS anyways? I am in a Critical Care class right now and they said that D5W actually works hypotensively since the dextrose metabolizes so quickly. I dont understand why they are putting a hypotensive solution with a blood prouduct... please help me understand

    ??
    I was wondering that too. I didnt think that sounded right, but then it may be a facility policy thing
  4. by   CritterLover
    Quote from jesskanurse
    i'm confused....why are they using d5w with the ivig instead of 0.9 ns anyways? i am in a critical care class right now and they said that d5w actually works hypotensively since the dextrose metabolizes so quickly. i dont understand why they are putting a hypotensive solution with a blood prouduct... please help me understand

    ??


    [font="comic sans ms"]ivig comes from different manufacturers. even though it is a blood product, different "brands" can be very different. we have one patient that has to have "gammagard." she reacts to all other brands. most likely, these differences are due to processing differences. at any rate, some manufacturers recommend d5w, some recommend ns. the manufacturer tests their products before making these recomendations, so they know best what their product should be infused with.

    keep in mind that while ivig is derived from blood, it does not have any blood cells in it, and giving it is not the same as "hanging blood." no t/s/crossmatch needed.

    also, while d5w can cause fluid shifts that will lead to hypotension, this doesn't hapen every time d5w is infused.
  5. by   Agent99
    We also premedicate with Tylenol and Benadryl.

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