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Discussion

IVs

Are there any special protocols for Giving IV iron? As a Home health nurse, our agency doen't specialize in IVs, so I rarely do them. Any tips...? :monkeydance:

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has the patient gotten iv iron before?

this is certainly an iv drug where the first dose must be given in a controlled environment. (such as a clinic with resus equipment readily available)

it actually needs to be given with a "test dose," which is a small amount of iv iron given (a cc or two) to check for a reaction.

a lot of people have very serious reactions to iv iron

once the patient has passed the "test dose," we usually give it over 30 min or so. i've seen some docs order it to be given over several hours; i'm not sure why. thirty minutes has been well-tolerated from what i've seen.

We do not give it in our agency. We feel that there are too many potential serious reactions to handle in the home. Some agencies give it and are comfortable with it.

  • Experts

I had IV iron given to me when I was hospitalized and was receiving a blood product at the same time. Actually the nurse on duty did not seem very concerned with me. I had to ring the bell and get her attention to let her know that there was something wrong with the insertion site. I ended up with a very painful phlebitis at that site that was uncomfortable for days afterward. She switched the IV to my other arm and soon after the iron finished running I developed a rash that is there to this day (a discoloration where the rash was originally red) more than a year later. I wonder if this could have been avoided. I don't think the skin discoloration will go away, if it hasn't done so in more than a year.

has the patient gotten iv iron before?

this is certainly an iv drug where the first dose must be given in a controlled environment. (such as a clinic with resus equipment readily available)

it actually needs to be given with a "test dose," which is a small amount of iv iron given (a cc or two) to check for a reaction.

a lot of people have very serious reactions to iv iron

once the patient has passed the "test dose," we usually give it over 30 min or so. i've seen some docs order it to be given over several hours; i'm not sure why. thirty minutes has been well-tolerated from what i've seen.

agree with the above. always establish if the pt. has ever had iv iron.

explain the possible reactions to the patient and instruct him/her to be sure to let you know if any are present.

allow only a very small amount to infuse initially (as stated above) and if all goes well, infuse the rest slowly. one hour is what our protocol was.

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