Pump vs Gravity for vesicants

Posted
by gcs1211 gcs1211 (New) New Student

Has 2 years experience.

Hello!

I was wondering if your institution allows running vesicants via pump and not gravity? 

Thank you!

DavidFR, BSN, MSN, RN

Specializes in Oncology, ID, Hepatology, Occy Health. Has 36 years experience. 486 Posts

All chemo, vesicant or otherwise, passes by pump where I work.

Our protocole is to check the reflux and permeability with a saline flush immediately before all chemo in both peripheral and central access.  And we pass all chemo by pump.

If you get an extravasation your pump will hopefully alarm pretty quickly. If your vesicant is running by gravity you may have a larger volume that's infiltrated before you or the patient notices. Then there's the issue of timing and products not running in too fast. 

I've seen an extravasation with Cisplatin, and it's not nice! I've also seen a faulty port-a-cath leak Ifosamide all over a patient, and while Ifo isn't a vesicant and the patient was OK, it still panicked the hell out of the poor lady.