Preventing phlebitis with Amiodarone

[baylordave16]

Perhaps I am the only one who has thought about this, but I would love to hear your thoughts. I got this idea when I had a patient with a #20 IV and no other access but amiodarone had to be started immediately.

Start a NS line and piggyback the amiodarone as far away from the IV site as possible into the NS line. It would dilute the amiodarone prior to reaching the patient and prevent as much irritation to the vein.

I know our protocol says to remove the IV site every 24 hours but I checked it and it looks beautiful and flushes great after the 24 hour period now that the amiodarone has been d/c'd. Absolutely no complaints from patient. I believe the latest research suggests that 24% of patients even with a large bore IV experience phlebitis after an amiodarone infusion so I was very pleased with this result.

[Lacy Lu]

Sounds like a good idea. Worth a try. :)

[CyclicalEvents]

At our facility we get the patient a PICC if we are going to start amioderone.

[NurseCollins799]

What rate do you run the nss? Is there any concern with dilution decreasing efficacy? I wish I could make the picc team appear every time I needed to emergently start amio! We run through piv's all the time, our policy suggests central or large bore, but we run it through 20s all the time.

[IVRUS, BSN, RN]

Because of its low pH (3-8-4.0) it is a medication which ideally should go via Central Infusion Catheter, however, when real life happens.. and there isn't a central line in place, I would choose the smallest catheter with the shortest length for the prescribed therapy. I would opt for a 22 gauge 1 inch catheter to decrease phlebitis risks versus a 20 gauge. The bigger the IV catheter, the greater the chances for phlebitis/thrombosis.