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 at 8 am. Should the trough be done right at 8:00 or at 7:00 am? Same with the peak - the vanco infuses for an hour so should the peak be drawn at 9:00 or 10:00? And no, we do not have a pplicy for this. The DON, ADON, and manager were arguing but were unable to decide. I figured I'd ask here. Thanks for any advice!
Jun 28, '05
Here's a link from a lab about it...
that's just one lab though...I went to many different sites, and the trough levels varied from 30 min prior to just before infusion starts...and the peak being drawn at anywhere from 30 min-120 min after infusion was finished, noting that more than one of the places I looked stated that the 30 min peak can be very variable as much as 10-15 mcg/ml for every 15 minutes...A few of the other sites I visited also stated that peaks aren't really effective for monitoring and dosing effectiveness of drug and are rarely used anymore...I don't work in an area that we need to do this type of testing anymore, so I'm not sure how valid that is.
Last edit by mommatrauma on Jun 28, '05