Vitamin K IV

JLBRN · Mar 20, 2006

I have given vitamin K IV, but due to potential for complications, I do not like it. I usually just give it really slow. I think complications are usually due to rapid administration.:heartbeat

Kudra · Mar 21, 2006

in our hospital, non-monitored patients can only recieve it sc and patients on a cardiac monitor can have it IVPB... our standard order is for 10 mg vit K and our policy is that it's given in a minimum of 25-50 mL NS and no faster than 1 mg/min...

Central WI RN · Mar 22, 2006

Kudra: Can you tell me if the bad reaction would be quick, like a code? Could it be slow, like a shock reaction?

Editorial Team / Admin · Mar 22, 2006

central wi rn,

here is a link about vitamin k administration in vitamin k deficiencies. you will have many questions answered here:

http://www.emedicine.com/med/topic2385.htm

Zee_RN, BSN, RN · Mar 22, 2006

Dang! I had the new pharmacy recommendations about avoiding SQ Vitamin K in my hand yesterday and I forgot to copy it! I haven't found it on an internet search but we did review it at a Unit Meeting last month. *kicks self* I'll try to remember on Thursday night when I work again.

RoxanRN · Mar 22, 2006

By our policy, only MDs give IV Vit K. Too much potential for clotting. We use SQ route routinely.

I just realized I misspoke...... we routinely use IM Vit K.

plumrn, BSN, RN · Mar 23, 2006

I never did like giving Vit K IV, and always gave it very slowly. The last time I gave it (several years ago), my pt almost coded. I had an uneasy feeling giving it to her in the first place, because she was so sick. I had her hooked up to a monitor, gave it slowly, and watched her closely, and sure enough she became diaphoretic, short of breath, developed pvc's, then semicomatose. I stopped it immediately, and we transferred her to the unit.

She did fine, but I wrote it up, and that one incident got our policy changed.

The docs still tried to get us to give it IV anyway for awhile, (except for the doc of the above pt-he thanked me for being so vigilant), but when we told them THEY could if they want to, they never took us up on it.

In an emergency situation, sure, but otherwise, I would never give it IV again.

kersti · Mar 24, 2006

We give vitamin K IV all the time to lots of patients. In all my years neither I nor any of my colleugues have ever had any problems with this route of administration. We give it reeeeaaaallllly slow and mix it with 10ml of NS before we administer it.

Zee_RN, BSN, RN · Apr 5, 2006

The reference that it is used in our new policy are The 2004 ACCP Recommendations for Vitamin K Use for Reversal of Elevated INR.

"Use of higher than needed doses of vitamin K can lead to warfarin resistance that can persist for weeks. These guidelines will allow for reversal of elevated INRs without inducing prolonged warfarin resistance."

Recommended #1 is ORAL vitamin K (on a doseage scale, based on INR and the presence/absence of bleeding). #2 recommendation is IV vitamin K (for life-threatening bleeding, an INR >20 or pt. NPO). Subcutaneous vitamin K is "not recommended due to unpredictable and delayed rate of response."

It also states that "Administration of a single dose of Vitamin K > 10 may result in resistance to warfarin therapy up to 7 to 14 days and recurrent thromboembolism."

dorimar, BSN, RN · Apr 15, 2006

Wow,

I don't think the docs have read this!!! Sq is still the main stream therapy wherever I have worked, and IV Vit K orders are highly discouraged by the pharmacy (of course, I can't remember when I've ever seen an INR >20--Is that compatiable with life?)