IVIG INFUSIONS IN THE OFFICE

[cjp]

The office in which I work will soon be doing IVIG infusions. I have never done these infusions before and feel very uncomfortable doing them in an out patient setting. Any words of wisdom?

[GInurse]

Explain to me what an IVIG is.

[NRSKarenRN, BSN, RN]

Have administered IVIG in pts homes many times.

IVIG=IV immune globulin

Start the infusion very slow 1/4 of desired hourly rate for first fifteen minutes. Check BP. If asymptomatic, increase by 1/4 for next fifteen minutes. Over next half hour if VS stable continue to increase rate every 5-10 minutes till ordered hourly rate acheived. If problems develop, slow drip or stop depending on side effects. I also titrate infusion down slowly over last 45 minutes.

Keep anaphylaxis kit with you. Be aware of potential side effects and have standing orders to treat.

Some patients can't tolerate recomended rate but do ok at 1/2 rate. Call prescribing MD immediately if problems develop.

Good luck!

[Mijourney]

Hi. I've never administered this med before, but in home health we deal with infusions sometimes that need close monitoring such as dopamine or TPN or certain antibiotics and antifungals. I've even heard that blood has been given in the home before.

I agree with NRSKaren, that you need to have an anaphylatic kit close by. Jeanie when you say you are doing the IVIG oupatient, is that in a hospital ambulatory care setting, a free standing setting, or a physician's office? You probably also want to have close access to a crash cart with these infusions. Best wishes.