IV antibiotic infusions

[kafo]

Greetings to everyone! I am new to this board and fairly new to dialysis after 20 yrs in OB. My question is re antibiotic administration. The hopspital I am with has both a free standing chronic and a smaller acute unit. The practice I see re: antiobitics is to infuse thru the needle after the run is finished. The med is allowed to free flow. This makes me shudder. Is there a protocol or reference I can refer to re this. I hope to approach my manager to improve our care, as there is no policies re this.

Thanks!

[NephroBSN, BSN, RN]

We are 24.7 miles from the nearest hosp and have no courier service for labs or blood. We (the staff) have to physically go pick up the blood and take any labs ie...BC's for fever, culture swabs, 24 hour urines. If we have a code we have to run it with all measures even if the pt is a no code per protocol because pts cannot be pronounced dead in our facilities.

Never a dull moment!

Juanay

Hmmmm I was always under the (mis,, maybe) impression that blood had to be adminstered within 20 minutes of picking it up from the blood bank. Of course I could be wrong..But then again..lolll

Nope never run a code in outpatient.. It's bag em Harry, run the saline wide open, O2, 911 and ship em Danno.

Well, now I take that back . I started a code in Maine at an inpatient chronic unit. Luckily I happen to actually look at the patient rather than the B/P monitor.. I didn't know the patient so I had no idea "She does this alot".. You mean she doesn't breathe alot??? HMMMMMM So we called the ED and they came. She didn't make it. Unfortunately.

[toney]

Question....for those of you who direct drip antiobiotics while the patient is still on dialysis (ie...Vancomycin) Do you attach to the arterial port? Are you concerned as to how much is getting dialyzed out? For antibiotics given after treatment....are you removing the air from the IV bags first? How do you feel about not using an IV pump?

at the center i work at antibioticc is done by gravity on the arterial medication line, my biggest concern is removing the air from the iv solution bag, and please shed some insight on how the blood in traveling through the patient body while on the machine

[writeone]

Our policy says we can infuse Vanco anytime during tx @ a rate of 500mg/30 min. We have an adaptor/infuser that regulates flow. No pumps. Everything else we infuse last 20 minutes of tx and place DFR into sequential so that it does not dialyze out.

:balloons: D

[bdhdrn]

Thank goodness we have pumps. I remember when we had pressure bags. one time the blood pump stopped when Vanco was hanging, she got a bolus-first time I saw "red man's"-never forget it!

Vanco over at least an hour. Gent, Fortaz, Ancef last 10 min push. Rocephin on a pump. Everything through the venous port.

Don't give blood in our unit any more, but when we did, it went through the arterial port also.

[donroberto]

Our medical director wants the antibiotics infused after treatment. We do not use a pump....we count the drips...look at the clock....etc. Some other units (same company) instill the A/B last hour....whatever...however....doesn't really matter.....just don't give 1 GM of Vanco in a short time......

[catherine-anne]

We give 1g of Vancomycin in the last hour and 1.5g in the last 90 minutes of dialysis through the venous chamber. This way the vancomycin doesn't go through the dialyser. We have to use an infusion pump or the pressure would make the blood go into the bag with the Vancomycin. We check the Vancomycin level every dialysis until the therapie is complete to make sure the levels stay in the limits wanted by the Doctor. Cathy