IV iron protocol??

In all my years, have never given it.

Hello JennyinLD,

in our general surgery unit we occasionally administer Ferric gluconate intravenously.

This drug is known to be compatible with normal saline only. We don't have a protocol for it, but:

We always administer this drug diluted in 100/250 ml of NS with very low flow rate (we haven't had any adverse reactions from patients).

The patients shouldn't go walking around the ward, but stay at their bed during the infusion (hypotension...).

As with every important situation (high alert drugs, patient returning from OR, etc.) I'd have a basal blood pressure taken, before initiating the therapy, and the patient should be informed about symptoms that can occur with this therapy , and to call if something's strange; the most important to watch out about are difficulty breathing, rash, classical anaphylaxis symptoms.

Iron IV is a classical vein irritant because of it's alkalinity, a slow rate of infusion helps with hemodilution, where a CVC is not present.

If there is hypotension a physician could decide to reduce the rate or temporarily stop the infusion, or use blood volume expanders if he wants to elevate the BP.

If there's an anaphylaxis reaction the therapy has to be discontinued and hypersensitivity treated.

Hope these few points are of help to you.

I have never given IV iron. However, knowing my hospital, there is a policy somewhere on how to give it!! LOL