Administering Vancomycin via venous chamber

[reginalin, BSN, RN]

Having problems whenever I administer Vancomycin. Whether it's pump (Braun Vista basic pump) or manual, the blood tries to back up the medication line. How to prevent the backing up because of the pressure in the venous chamber? Thanks.

[Chisca, RN]

You have to increase the pressure limit on the IV pump to overcome the pressure in the venous chamber. Some pumps can't. The arterial side has negative pressure so it isn't a problem if you run it on that side. Some nurses feel that more of the drug is removed if you pass it by the filter first but I disagree. Vancomycin is not protein bound and has a small molecular size. Running it on the venous side does not prevent the vanc from passing by the filter, it just delays it by a few minutes as it circulates through the blood stream and comes back through the filter.

[Chisca, RN]

Correction. Vancomycin is 40% protein bound but that other 60% is easily removed by high flux filters. The molecular size is actually large at 1448 daltons.

[GeauxNursing]

I was trying to give vanc today through the venous chamber, too. I kept getting Down-line occlusion alarm on the pump. I got so frustrated. I do not care for the Nipro dialysis lines. I ran it through the NS pigtail pre-pump.