Vanco Administration Question Please! - page 2

by suzi0612 | 7,251 Views | 14 Comments

Hey Everyone, I recently started a job in a clinic and only have been a RN for almost a year and had a question. I have not worked in the hospital and only start IV's in the clinic a few times... but today we had a patient that... Read More


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    I have seen "red mans" in children with a slow infusion. It is something you will never forget. Find out what your clinic policy is and discuss the situation with your immediate supervisor so next time you have some back up. When it happens again, and it likely will, simply explain that performing this is against policy and you cannot do it...if the doctor chooses to do it himself, document everything in a diplomatic non-accusatory manner. You can then control your your situation better and continue to provide optimal patient care so the patient gets monitored for adverse reactions. Notify your supervisor if the breech of clinic policy by the physician or file an incident report for patient safety. You cant go wrong following policy, being professional, and providing good patient care.
    Esme12 likes this.
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    1st question- was it wrong telling him i wanted to use pump because i did not feel comfortable, it felt safer for me and the patient
    no your not,you have to used your judgement to safely administer the medication.you are absolutely right in telling him the best way of administering vancomycin.if it is a small dose (250mg)then yeah i would probably just calculate it without a pump and if this is a regular meds(patient has been taking it for few days)the fact that this is the ist dose/time the patient recieving the meds.


    2nd- can you give vanco just through a primary line without piggy backing? (because he told me to stop it and just do the vanco)

    yes you can give it as a primary iv without piggy back.in fact and in practice 1000mg of vanco can also be mix in 50ml but give it slowly(1-1.5 hrs) or the safest is 250 ml in an hour...just like any other meds given rapidly can cause harm as previously mentioned by others here.

    you did absolutely well..good for you.......... you stand for what is right for you and for your patient.
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    You did a great job being an advocate for patient safety. I have once had to give Vanco in the home and I told the agency that I would not do it if there was no pump available, or elastomeric system.
  4. 0
    That is so odd OP, I wonder where this MD had his residency... hmmm.
  5. 0
    You can give the Vanc without a pump, and it can be piggybacked. Just because you are running out without a pump does not mean that has to be run it "wide open" and you can still control its rate. Of course some infusions, for example, KCl, NTG, and heparin, must be run on a pump.

    As for volume, I've always seen Vanc (be it 1 gram or 1.5 grams) in 250 NSS or D5 and it gets run over 2 hours. The doc may have been right that it can go without a pump (what is the p/p of the facility) he was wrong that you can "bolus" the vanc. Also, why does he care if you only feel comfortable running it with a pump?


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