HSR in Outpatient Chemo Infusion

[mackyclaire]

Hi all, I am an experienced nurse, but new to chemo infusion and I have two practice questions for those with ore experience.

1.When a patient is having a true hypersensitivity reaction, obviously I stop the chemo immediately, but when I clamp that off and open the line with NS, it’s still pushing some of the chemo in first. Do any of you keep a separate primed NS bag as a backup and if they react just disconnect the chemo set and attach the pure NS line instead? I’ve gotten so many different answers from co-workers and observed varying practices so I am curious as to what you all do.

2. Prior to giving a chemo prone to HSR, many of the nurses who have precepted me will make the rate 999 for 20-40cc to get it closer to the patient before starting. I do this with blood but it makes me nervous bc I can't really tell where the chemo starts (even though it's obviously around 20-40cc for the remainder of the line). Is this common practice?

TIA!

[Nursey103, ADN, RN]

1.  I stop the chemo and hang a new bag/line of saline.  My co-workers all jump in when there's an HSR so if I'm stopping the pump, another nurse is already priming the NS, another grabbing the vitals machine, another grabbing the HSR meds.

2.  I have never done this and I don't understand why someone would.  Just program the pump to run at the prescribed rate and when the bag is empty, start the flush.