Frightening events during chemotherapy

[pickledpepperRN]

An oncology nurse friend told me a patient can seem fine, walking and talking yet die in the first twenty minutes of chemotherapy infusion.

Can someone tell me more?

Has it happened to your patient?

What do you do?

What about outpatient chemo?

They do it in a special room in the inpatient unit where I recently floated. Loved the patients, but scared because I don't know this specialty.

[gwenith, BSN, RN]

I agree with Stevirae here - minimum is suction - twinovac or something - crikey a foot pum would be better than nothing. So, you have ambubags, fine, tell me how are you going to manage the airway of a full on anaphylaxis who has laryngospasm???

[leslie :-D]

my mother, on her 3rd day of continuous infusion started c/o abd pain, radiating to her flanks.

they gave her morphine.

on day 5 the pain was intolerable and that's when they decided to get her a ct scan which showed gross colitis of the lg and sm bowel.

why didn't they get her that ct scan on day three rather than just medicate?

she ended up dying from the toxic effects of the chemo but will never understand why they didn't run any tests when she first started c/o pain?

[caroladybelle, BSN, RN]

NO CRASH CART!!!!

Please tell me that you don't give L'aspariginase or the really volatile biologicals, with high anaphylaxis potential.

It is one thing to be giving old line drugs like the Vinca alkaloids, where there are few problems...but pretty scary to be giving some of the newer biological agents.

[renerian, BSN, RN]

You can be onc certified but the chemo classes itself don't certify you. Separate issues.

renerian

[curleysue]

I think if I was getting chemo I would make sure to ask that they have a crash cart available with EVERYTHING on it. I cannot believe they would give chemo without it. Scary!

[Ted]

This thread was started in 2003!

Some of these new chemotherapy agents are quite scary! The "biological" stuff is all quite new to me! Got to read up on them. I do know that there are significant risks for anaphalatic shock and require CLOSE monitoring when giving some of these agents. A crash cart on a unit that provides these newer (riskier??) agents should be a "must", I would think! (At least have a epi, benadryl and some kind of IV steroid real close by!)

Ted

[caroladybelle, BSN, RN]

This thread was started in 2003!

Some of these new chemotherapy agents are quite scary! The "biological" stuff is all quite new to me! Got to read up on them. I do know that there are significant risks for anaphalatic shock and require CLOSE monitoring when giving some of these agents. A crash cart on a unit that provides these newer (riskier??) agents should be a "must", I would think! (At least have a epi, benadryl and some kind of IV steroid real close by!)

Ted

Heavy doses of premeds with much of these...the combo varies by facility.

Most patients getting "high risk" agents, get Benedryl, Tylenol, Pepcid (or Zantac/Tagamet), Solumedrol/decadron and an antiemetic (Zofran/Anzemet/Kytril/Emend) prior to receiving these agents, Ted. And even with alot of the above on Board, they still can crash on us.

[wiegel34]

I am a "Chemo certified nurse" I have taken a certification test called Oncology Certification Test. I have a national certification and am qualified to give Chemotherapy drugs. I studied for 2 years on my own then took a 5 hour test, which I passed. I am registed with the Oncology Nurses Society as an Oncology Cerified Nurse. My cerification is good for 4 years, then has to be renewed by either retesting or by having completed 100 CEU's, of which 65 have to be Oncology related. So their are Chemo Certified Nurses.

[Lainee]

I have seen severe anaphalactic reactions to TAXOL. It is very scary but the pt usually recovers once the drug is stopped.

same here. and we have restarted it slower after a break and steroids.