sodium bicarb infusion

[susieok]

hi... just wanting to clarify the administration recommendations for IV sodium bicarbonate in regards to patients with high dose Methotrexate protocol.

on the previous oncology ward i worked on, we always administered sodi-bic 100ml 8.4% bottles over 1hr undiluted if they had a CVAD and diluted in 500-1000mls over at least 4hrs if going through an IVC due to the risk of tissue damage.

i'm now working in the oncology day unit(chemo unit) and recently a woman came down from the gynae ward to have high dose methrotrexate for diagnosis of GTD. her urine pH was only 5. the doctor ordered her to have 100ml bottle of sodi-bic 8.4%. the day unit had been infusing these over 1/2hr undiluted into people with IVC's. i questioned this practice with the pharmacist who stated it had to be over 4-8 hrs. back on the floor the nurse mgr told the other nurse just to hang it over an hr undiluted until her urine pH rose above 7. the first bottle didnt, so the doctor ordered a second bottle, and the nurse infused half of that until her pH rose. i refused to do any of the checking as i didnt agree with this, but the manager decided her decision was correct.

i'm after any information from oncology nurses who can tell me how they administer this drug in their unit. i have googled this and found that a rapid infusion via IVC is only recommended in cardiac arrest situations... but ineterstered to see if i'm correct or whether infact other onoclogy units are infusing this drug rapidly. thanks!