Banana Bags. Etoh. Rate.

[JeepAnnie]

Hey guys.. I've got a question.. Hope I don't sound too dumb...

Banana Bags.. the hospital I work at always does Etoh levels first, is this a must? I just didn't know if the level of alcohol has anything to do with what goes into each bag. Also, the rate... We normally hang the Banana bag at the rate the primary iv will be at when it is done (after 3 days). However the other day I had a patient with several different orderes 1. LR @ 83 2. Banana Bagx200ml/hr. 3. Banana Bag over 24 hours.

Hello can you say confusing! The nurse prior to me had the rate at the 200ml/hr. However I changed the rate to 83 when I got the patient, and yes I know I should have called and asked what the doctor wanted. Also the combinations.. I know each banana bag is different.. Our is usually vit K, LR, thiamine, folic acid, mag sulfate... so if we would have ran the patients iv at 200/hr for the 3 days... would this have caused issued with blood clotting/vit k?

[ayla2004, ASN, RN]

A banana bag is a merely a bag of IV fluid (In my limited experience, I've seen D5LR and D5NS) that has added to it multivitamins, magnesium, folic acid, and thiamine. And in some places/situations, apparently, vitamin K.

It's called a "banana bag" because the MVI solution injected into the bag gives dyes it a yellow color.

in the Uk we call it pabinex(sp)

[CABG patch kid, BSN, RN]

This might sound really really stupid, but any chance that vit K was misread and was actually KCL? I don't know, nobody has mentioned it as being in the bag. I'm on 2 hours of sleep here so excuse me if I'm mistaken, lol.

[massrn116]

I believe Vitamin K is contraindicated IV since one of the side effects is DEATH from IV injection. Have never given IV. Banana bags for us, MVI, folic acid and thiamine IV unless the patient can take all 3 PO.

[cardiacRN2006, ADN, RN]

I believe Vitamin K is contraindicated IV since one of the side effects is DEATH from IV injection. Have never given IV. Banana bags for us, MVI, folic acid and thiamine IV unless the patient can take all 3 PO.

Oh, I've given Vit K IV before...it's a plausable administration route. It was just really rare due to this specific pts habitus.

He was large, and very, very edematous.

And for the pts who can't take a lot of fluids (even the condensed 500mL banana bag) we usually give the vits IM, since most of my pts have dead bowel anyway (or very, very quiet not working at the moment bowel, or GI bleed, etc, etc)

[hypocaffeinemia, BSN, RN]

I believe Vitamin K is contraindicated IV since one of the side effects is DEATH from IV injection. Have never given IV. Banana bags for us, MVI, folic acid and thiamine IV unless the patient can take all 3 PO.

You're right and wrong.

From micromedex:

1.3.1.A Important Note Phytonadione should be used intravenously or intramuscularly only when unavoidable. Severe reactions, including fatalities, have occurred with intravenous and intramuscular administration (Prod Info Aquamephyton®, 2002).

--

It goes on to list IV route dosing and administration.

My guess is that the adverse reactions are linked to the signifcantly higher (therapeutic) doses and not a supplemental dose.

[fmick]

At our facility I made the policy regarding what goes into the banana bag because of the confusion involved. We have many doctors that are travelers and nurses as well. We use D5NS with 1mg Folic Acid, 100mg Thiamine and two vials of adult multi vitamin. We do not run it open usually which is why I was checking the site only to be further confused as to how many ways there are to run it. I believe that open is too fast.