vancomycin and peripheral iv's - page 2

Can anyone give me any sites or info on whether or not you can give vanco in a peripheral iv. A co worker and I were discussing it but I can not find any evidence based info. thanks Dawn... Read More

  1. 0
    When I was in medicine we would generally plan to get a PICC placed if a patient was found to need Vanco by ID--they were usually the docs seeing these infections that were resistant to other ABX-- they would tell us it was okay to give a few doses via a peripheral line but generally the nurses would be nagging the docs saying--Hey...this patient has been on Vanco for 2 days or 3 days or whatever and hey did you want to go ahead and get a PICC put in? Sometimes they woudl forget so we were kinda the ones making sure they were aware the Vanco was still going through the ordered Peripheral. I found that they usually would be appreciative of the reminder and say...oh yeah, you're right why don't you go ahead and call the PICC team and I'll write that order!
    So there the nurses were pretty on top of that-- Vanco is hard on the veins so giving it for too long via a peripherial line can cause some pretty nasty damage. A few doses is okay.

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  2. 0
    I remember having to hang a loading dose of IV vancomycin for one of my patients. It was to be run over 90 min, though I like to run it longer than that given it is so irritating to veins...so I made sure the IV was patent, hung it, came back after 45 min and unfortunatey I could tell that the IV had gone interstitial. His arm was a bit puffy and red, looked painful though the patient denied any discomfort. I immediatley discontinued the IV, started it on the other arm and ran the rest through without problem. Though I have to wonder, given that this was the loading dose, would this scew the next vanco draws? I was assured from collegues that it shouldn't as most had infused. Poor guy, I hope that the swelling and redness goes down HATE PIV Vancomycin!!
  3. 0
    It is commonly given in PIVs on my floor.

    Someone on the vascular access team at my hospital taught me that, if you have a choice, you should pick the SMALLEST PIV for Vanc. So, if the patient has an 18 and a 20, you should run the Vanc through the 20. This is the opposite of what I would have assumed. However, he explained that smaller IVs have more blood flow around the catheter and therefore the Vanc gets mixed up and diluted with the blood faster and you decrease your risk of damaging the vessel (compared to a bigger PIV that doesn't have much blood flow around it).
  4. 0
    I hate giving Vanco through peripherals. At my facility we always run it for 2 hours, usually at 125ml/hr. If they suppose to have Vanco for an extended amount of days, than we asked for a PICC line.
  5. 0
    I've never thought twice about giving vanco through a patent PIV because that's the way we do it at my facility. The only time I advocate PICCs have been on patients with very scarce veins and on multiple antibiotics. Thanks to all of you now because I'll do better
  6. 0
    I hate infusing vanco through PIV's. The IV site almost always goes bad. No me gusta.

    Recently, pharmacy mixed a piggyback of vanco for my patient. It was 1,750 mg in 500 ml's and the label said to infuse over 1 hour. I was like, "no way Jose," and called the pharmacy to report the error. Yikes!
  7. 1
    Quote from noyesno
    I hate infusing vanco through PIV's. The IV site almost always goes bad. No me gusta.

    Recently, pharmacy mixed a piggyback of vanco for my patient. It was 1,750 mg in 500 ml's and the label said to infuse over 1 hour. I was like, "no way Jose," and called the pharmacy to report the error. Yikes!
    LOL! now that's ridiculous!!!!!
    noyesno likes this.
  8. 0
    We change IV sites every 3-4 days at my faculty. Many times vanco shortens the life of the PIV. Our pharmacy is good enough to put the infusion rate in our MAR, so we can double check when we check it off as completed.
  9. 0
    I've rarely blinked at the idea. Sorry, I can't fight em all.

    Honestly, I've seen WAY less complications with IV vanc than I have with IV amio and yet vanc is categorized as worse.
  10. 0
    working with what you have, i'd dilute it, run it slowly, and administer it at its most distal port.
    then monitor, monitor, monitor.

    leslie


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