For instance, I have a patient that was admitted Friday night, he was ordered Vanco 1gm Q12hrs. He is "probably" going to be D/C'd tomorrow on PO Vanco. INS says not to give Vanco through a PIV. I could not get the doctor to order a PICC; and I don't think that it is really necessary. The fellow has a good 20ga in an AC vein, he hasn't complained of any pain, etc. Everything seems to be going well.
I'm trying to get a PICC team/person/protocol for when we need one set up at our facility. So my question isn't just simple conjecture.
Does INS or AVA give a time limit that "no PIV" meds can be given through a PIV? I think INS says something like, "in emergency" or "until central access can be made" or some such....
If the pt is going home with PO vanco, then they can take it now because they have
C-diff--oral vanco and flagyl (IV or PO) are usually the best choices. I don't know of any other circumstance where PO vanco is used. If the pt is being treated for MRSA and is going home on IV vanco, they need a PICC line.
At my facility, we give vanco all the time through a peripheral. Most post-op pt's with PCN allergies will get vanco instead of a cephalosporin. Short term abx are usually given through a PIV--long-term abx will eventually need a PICC. Some pt's who are really hard sticks will get a short term IJ instead of a peripheral.
Interesting topic I work peds and give my kids Vanco through peripherals all the time...no policy or such contraindicating it here. The only reason we put PICC's in r/t IV meds is if the pt is going home on them/going to be on IV meds for an extended time in the hospital/ or the the pt will also be on TPN.
scootertrash nurse
49 Posts
I agree with above posters ! is the patient going home on iv meds?? but vanco goes ok thru piv's