Does anyone out there know if there is definitive guidelines for administering dilantin via PICC lines. There is some literature about it that says "no" and some that say "yes" and some that say only if you have no other choice. I understand that it precipitates very readily in PICC's and wonder if it's and old recommendation? Anyone?
Oct 31, '07
we basically avoid giving dilantin through a picc. because the lines are longer than other CVC's there is a much longer distance for mixing to occur even though priming volumes are usually smaller. Unfortunately,no matter what we have done including repeated training (i.e. use NS before and after,using a .22micron filter if in a mini bag) has helped ,we eventually lose our line and have to exchange or re-site. Remember that Dilantin has a ph of 12 (draino has a ph of 12). Giving it through a short peripheral is an option ----just monitor for infiltation /extravasation. Also a chest line is good also---do not forget adequate flushing with 10 mls NS before anf after----keep post flush same rate as push rate or pt could experience bradycardia. my favorite solution is Fosphenytoin ---compatable with D5W but it is costly. by the way Peds has banned the use of Dilantin through PICCs as long as I can remember hope this helps......if you continue to practice this ..you will lose your PiCC. I just re-did one 2 days ago
Last edit by iluvivt on Dec 13, '07
: Reason: spelling