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Free Flowing Fluids With Vesicant Chemo

  • 1.  Free Flowing Fluids With Vesicant Chemo

    Posted 09-11-2019 08:50
    It has come to my attention, through my involvement with AVA (The Association for Vascular Access), that some nurses have been using pumps with their flush bag when pushing vesicants. When I mention "free-flowing" they do not know this means by gravity. Neither do they understand the rationale behind this standard practice.
    Any comments?

    Erik Samarpan, RN, VA-BC, CLNS
    HHS/IHS- Phoenix

  • 2.  RE: Free Flowing Fluids With Vesicant Chemo

    Posted 09-16-2019 12:31
    Hi. The following statement is from the ONS Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice

    "Use IV pumps with dose error reduction software, when possible, for the administration of infusions of chemotherapy, targeted therapies, and immunotherapy, excluding peripheral administration of vesicants (ISMP, 2018)."

    The reference is the following statement from the 2018-2019 Targeted Medication Safety Best Practices for Hospitals

    "The only exception is for small volume vesicant infusions (i.e., chemotherapy vesicants) which, when administered via the peripheral route, should only be infused by gravity and NOT by an infusion/syringe pump."

    Mark Vrabel
    Oncology Nursing Society
    Pittsburgh PA

  • 3.  RE: Free Flowing Fluids With Vesicant Chemo

    Posted 09-17-2019 02:34
    So ive tried to educate on this and what i have seen or i should say the practice is at my centerputting the vinca below the pumping iv and they consider this free flowing its so frustrating because my supervisor doesnt see an issue its being pumped in!!!! My other frustration is that the nurse will set it up this way and walk away when orders say that nurse needs to be by pt during whole infusion