Vanco peak & trough times - pg.3 | allnurses

Vanco peak & trough times - page 4

What is everyone doing about drawing peaks and troughs? At my LTC facility, we have a patient with a PICC. The lab does not draw from PICC lines so the RN has to do it. The patient gets Vancomycin... Read More

  1. Visit  Gompers profile page
    Quote from TBLPN
    I just did this this morning. The order was specific. Draw the trough one hour before running the Vanc and draw the Peak one hour after infused. At my facility lab doesn't draw from a Picc either. But I"m an LPN and we do. I love it it's great.........
    Are you drawing your vanco levels from the same PICC the vanco was infused? Where I am, that's a big no-no - it can alter the results, giving falsely high vanco levels. We cannot draw any drug levels from any lines where that med was infused, unless there are multiple lumens and it's not the one that the vanco goes through.
  2. Visit  TBLPN profile page
    At our facility we draw the trough (usually) just prior to hanging the vanc. We draw the peak an hour after infusion. If it finishes at 7 am we draw at 8 am. BUT we have a doc that specifies.......he wants the trough drawn one hour prior to infusion and one hour after.........that makes it pretty simple.
  3. Visit  ginger58 profile page
    Quote from alterson
    What is everyone doing about drawing peaks and troughs? !
    Whether it be an infant or an adult, 3 different hospitals draw the trough 30 minutes before the dose. Where I am now the pharmacist gets the lab value and adjusts the dose. Other places the NNP/neo have adjusted the dose. So, I guess I would find out who manages the dose and ask them.
  4. Visit  nursebuxom profile page
    This week I had a discussion with the ID about this issue. The rules for vanc have changed it seems. They used to do a peak and trough to ensure that the level was not toxic, now the goal is to keep the level up.

    We draw ours one hour before hang time, and do not hang until lab results are back and if out of range, reported with orders given.

    Peak is drawn 30 minutes to one hour after completion of infusion. The infusion time varies with the dose ordered, but we have been told to make sure the iv will hold for the dose because if it takes too long to hang, the therpeutic benefit will be lost. We've also been told that if the site is lost during infusion (and another not immediately available), notify the pharmacy or the MD for orders on the remaining amount. Apparently, after a while, there is no point in running the remainder of the dose.

    Did that make sense?
  5. Visit  YHVHdaughter profile page
    I've been working via an agengy at an acute care hospital. A Vanco trough was drawn on my patient (after only receiving one dose 12 hours prior) and I hung the Vanco within the next half hour after the lab draw. Apparently this is wrong? After the Vanco level came back high I was told I was supposed to wait until the Vanco level came back prior to hanging the dose. I've never done it this way. Firstly, I've never heard of drawing a trough prior to 72 hours after the first dose. Secondly, how often can one expect lab results back within 30 minutes? ~ Not very often! Is this standard procedure?
  6. Visit  ProfRN4 profile page
    It was always my understanding that the trough you draw before the dose will subsequently affect whether you give the next dose (not the dose you are drawing the level right before). If the doc did not wright "draw trough level at 12pm and hold 12pm dose" why would you hold it? Unless this specific institution has a policy stating you hold the dose that you are drawing the trough before, then you are not wrong (IMO).

    This is the problem with nursing; too many variations on things that should be standard