vancomycin and peripheral iv's

  1. 0
    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.


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  2. 19 Comments...

  3. 0
    Yes, you can give Vanco using a PIV, both in adults and neonates. My Nursing Drug Handbook states IV use, no mention of central lines.
  4. 4
    CAN you do so? Sure,it's done all the time. SHOULD you? That's a little different. When deciding if a med needs to be infused centrally or not,one of the considerations is the pH of the solution. Very high (alkaline) or very low (acidic) pH solutions should be given centrally. If given peripherally,there is a high risk of damaging the inner lining of the vein and causing phlebitis or thrombus. Vancomycin is one the more acidic drugs out there,with a pH of 2-2.2,no matter how it's prepared. For comparison,the pH of normal stomach acid is 1-3.
  5. 2
    PICC/ Central line is the preferred route; peripheral is accepted if necessary. Administration via midline is not an acceptable route. Will try to find the source for you; these recommendations came from an IV CE course I took a couple of years ago.
  6. 0
    Reference for the above is the Infusion Nurses Society standards of practice from 2006. "Therapies not appropriate for peripheral-short catheters include continuous vescant therapy,parental nutrition,infusates with pH less than 5 or greater than 9,and infusates with an osmolality greater than 600 mOsmol/L."
  7. 1
    totally agree with PICC ace . Do not delay a dose while waiting for a CVC. Start a PIV then secure an appropriate CVC as soon as medically feasible. Plan ahead and if you know patient will require abx for awhile request a PICC be placed to preserve the peripheral vasculature.
    iloveny68 likes this.
  8. 0
    I have found that the facilities where I work you have to pull teeth to get a PICC even after trying to rationalize with them that the patient will require a harsh med over a long period of time.
  9. 0
    Had an incident just last night over PIV infusing Vanco on AM shift, site very, very edematous, red, hard, and painful to resident. Pulled line, started another, wrote incident report, talked with DON, and of course, since this was an incident involving one of the pets, was told "just do not let it happen again." WHAT!!!!!!! I found the mess, I did not create the mess, I had been off and this was a new resident to me. Even in resident who have ports and other devices, this facility wants an Act of God to use them. Just another reason why I am looking for a new job.
  10. 1
    The Infusion Nurse Society standards indicate that meds with a high pH or very low pH should not be infused peripherally. That would be pH < 5.0 or > 9.0 or with osmolarity >600. (I think)
    rn2bmaryg likes this.
  11. 0
    We do give Vanco via a PIV but I hate doing it. I remember a time when giving Vanco was a major event and it was a medication that was rarely used. At that time, it had to be infused via a central line. I frankly don't like infusing it via the PIV route.

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