IV's,a thorn in my flesh.

  1. When giving 1200mg of vancomycin thru a PICC line why must a filter be used? and can any filter be used? I was told I must use a filter but the one that was previously on the line was no longer available so the head nurse said use the in line filter thats available.
    Also the unit has no 250cc NS bags into which the Vanco should be given in so they are withdrawing 250cc out of a 500cc NS bag to make 250cc to give th vanco in,which takes extra time. Why cant we just give the whole 500cc with the Vanco in it?
    Also I hate IV therapy cause it takes so much time to prepare the meds,find the equipment ,figure out how much to use and how much to dilute,etc. and etc.
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  2. 19 Comments

  3. by   charissa
    We have always used filters at my facility for tpn, vanco, gent, and others, recently however, our pharmacy stopped supplying filters for vanco and has told us that because it is different than it used to be we do not need to use filters with it (they always send our filters up with the vanco bags) just a thought
  4. by   BBFRN
    Hav you tried asking the pharmacy to pre-mix it for you? That way, you don't have to worry about taking the time to draw up the 250 cc's.
  5. by   Agnus
    No filters are currently needed with vanco. However, when a filter is needed you should used the one supplied with the med. If you get a filter with vanco use it. CYA.
    If you must use a filter and don't have one supplied find out what size you must use before.
    These are questions for your pharmacy dept to answer.
    I would have to question the practice of drawing off 250 cc to mix your vanco with the pharmacist. It might be ok but....?
    Unless it is after hours your pharmasist should be supplying the vanco already mixed.
    I do mix it after hours if it is an new order or a change order that I got after pharmacy left.
    When ever you have questions you should have the ability to phone the pharmasist and get a difinitive answer.
    You are working in a dangerous area if you are mixing this all the time and without pharmacy guidance and with out access to the pharmasist.

    These are NOT nursing questions they are questions that only the PHARMASIST is truly qualified to give you the best and most up to day info. on.
    What the heck is going on at you facility that you don't have ability to talk to a pharmasist?!!! Please, be safe.
  6. by   katfoster
    We use tho filter everything now we only filter TPN , Dilantin, Manitol, and Amioderone. We did a study and nothing else really needs to be filter. We were spending thousands on dollars of filters which are not necessarily needed. Call around no one uses filters anymore.
  7. by   OzNurse69
    We don't filter TPN or drugs either - only things we filter are blood products.
  8. by   New CCU RN
    We filter blood products and Protonix..... that is all I can think of..don't know bout Dilantin or Mannitol.... but Amiordarone, TPN, Vanco...none of these I have ever seen filtered!!
  9. by   WalMart_ADN
    the only thing we filter is protonix(????) and pharmacy sends the filter up with it.....we have to dilute our IV meds on the floor, but usually pharmacy puts a "Dilute in 50 cc's NS and deliver over 30 mins"...usually...not always...
  10. by   WalMart_ADN
    we obviously filter blood products too.....why is it that protonix is filtered? noone knows on my floor, and pharmacy always says "it's recommended by the manufactorer"
  11. by   emily_mom
    All of ours always comes up premixed. Helps us with not having to do it all and they have a sterile area where it can be mixed. Also helps with nurse error, which is why they do it. Fine by me...
  12. by   MelRN13
    We filter tpn and protonix, and the only answer I've ever got is "it's following the protocol"...................who made the protocol in the first place? I have never heard of filtering vanco, and I have a mixing cheat sheet at work, I'll try to remember ( suffering from crt during holidays) to bring a copy home and post it.
  13. by   ohbet
    Thanks for the replies,you all really know what your talking about,I wish you worked at my hospital.
    Just to respond to a few of your points.
    Our pharmacy doesnt pre-mix anything,but I am going to ask him about the filters,the dilution etc.
  14. by   AmAnRN
    someone at my hospital said the particles in protonix could make you go blind if its not filtered. i am not sure what other side effects.

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