The loss of drug in the tubing exceeds the 5% dose variability acceptable for our chemotherapy doses per our hospital policy. Bookshelf 2141 0 obj <>stream An official website of the United States government. 125 Enterprise Drive sharing sensitive information, make sure youre on a federal Methods The ASCO/ONS Chemotherapy Administration Safety Standards were rst published in 2009 and updated in 2011 to include inpatient settings. Oncol Nurs Forum. 3. Ensure the best possible outcomes with ONS standards. Facebook - National Cancer Institute Eur J Oncol Nurs. Pediatr Rep. 2012 Aug 1;4(3):e28. Nurses play an integral role in determining whether an infusion is appropriate for primary or secondary infusion. Chemotherapy and Biotherapy Guidelines and Recommendations for Practice. {M@C:NiD(mXx?0/a`1Y$,X6iF ~,e!|;b`H30dhfN@+T@ 8 endobj 2.13.2 Vesicant chemotherapy administered through a peripheral intravenous must be infused IV push as ordered or via a short-term gravity intravenous line. J Oncol Pharm Pract. The https:// ensures that you are connecting to the Answer:Yes, the product is stable in a minibag. Conclusion Antidote and treatment recommendations of vesicant chemotherapy manufacturers, antidotes and treatments approved by the U.S. Food and Drug Administration (FDA), and guidelines and recommendations made by professional oncology organizations are useful resources in this process. Ryan Rodriguez, PharmD, BCPS Vesicants and irritants with vesicant . Also, dilution of the vinca alkaloid likely reduces the impact of any extravasation that might occur. The practice of monitoring the administration of vinCRIStine and other vinca alkaloids in a minibag to avoid extravasation via a peripheral IV is essentially the same as if it was administered IV push. Centers for Disease Control and Prevention. Prepared by: No solid research exists regarding IV chemotherapy administration setups, because they can vary greatly based on the regimen, equipment availability, and patient status. The information presented is current as of August 2, 2021. Furthermore, in vitro evidence suggested that vancomycin-associated endothelial damage is caused by factors other than pH. The vinCRIStine is infused via gravity through the peripheral line. 1998 Jul-Aug;21(4):232-9. Clipboard, Search History, and several other advanced features are temporarily unavailable. 6. Rev. Seo H, Altshuler D, Dubrovskaya Y, et al. Irritant: Medication that can cause local inflammatory reactions at the infusion site, which may include: burning, swelling, pain, inflammation, tightness, or phlebitis. A similar sized bag for the back flushing, such as a 25 mL bag of 0.9% saline is used for both adults and pediatric patients. Use a central venous catheter or implanted device for continuous vesicant infusions or for any vesicant infusion lasting longer than 30 minutes. 2,3 Initial symptoms of extravasation are similar to infiltration and include persistent pain, burning, stinging, swelling, and . official website and that any information you provide is encrypted A study in Australia involving 68 cancer centers evaluated more than 44,000 doses of vinca alkaloids administered via syringe or minibag to adult and pediatric patients, found that the extravasation rates were similar and low0.03% with syringes and 0.04% with minibags.1 Preliminary data from another study conducted in children and adults found no cases of extravasation during administration via minibags.2 These data strongly support the safe use of minibags in adults and children.3 The risk of extravasation injury doesnt compare to the risk of severe neurological injury and near certain death resulting from the intrathecal administration of vinca alkaloids. Additionally, patient mobility is greater with midline catheters because of the location of their insertion site.2 Lastly, compared with drug administration via peripheral IV catheter, the risk of phlebitis may be reduced with administration via midline catheter because of its termination in an area with a higher rate of blood flow.2The rates of CRBSI have also been reported to be lower with midline versus peripheral catheters (0 to 0.2 versus 0.5 per 1,000 catheter days).1, Overall, the properties of midline catheters may make them preferable for specific durations of therapy. If not clearly defined in the literature. 2013;1(1):9- 16. Please enable it to take advantage of the complete set of features! A central line is always required for vesicant or any chemotherapy in the home. Remove cold pack at least 15 minutes before dexrazoxane therapy. Reference: 1. The .gov means its official. Midline catheters differ from other VADs with regard to their insertion and termination sites.1,3Midline catheters are inserted peripherally into the antecubital fossa or upper arm via the basilic, cephalic, or brachial vein, and extend from 8 to 20 cm centrally, where the catheter tip terminates at or below the axillary vein. Question: Our pediatric department is reluctant to administer vinCRIStine via a minibag through a peripheral IV line since many of our patients do not have a peripherally inserted central catheter (PICC) or central venous access device. PDF Irritants and Vesicants Guide to Intravenous Administration via Midline and transmitted securely. Cold - Apply cold packs for 15 to 20 minutes four times per day for 1 to 2 days. http://opp.sagepub.com/content/early/2014/01/13/1078155213517729. eCollection 2018 Apr. Reviewed electronically by nursing reference committee. Email ONSs clinical inbox at clinical@ons.org to reach one of our oncology clinical specialists, who can advise on ONS recommendations, best practices, and evidence support. **Some case reports of extravasation and injection site reactions or inflammation have been reported. Vesicant: An agent that has the potential to cause pain, inflammation, blistering and irreversible tissue damage, including necrosis and loss of limb function and mobility. Chemotherapy and Biotherapy Guidelines and Recommendations for Practice. NCI's Dictionary of Cancer Terms provides easy-to-understand definitions for words and phrases related to cancer and medicine. 3/10/2014, 6. 1 Infiltration, often used in reference to extravasation, refers to leakage of a non-vesicant drug or solution. Safe Administration of Chemotherapy: Safety During Chemotherapy Ordering, Transcribing, Dispensing, and Patient Identification Safe Administration of Systemic Cancer Therapy: Administration of Chemotherapy and Management of Preventable Adverse Event
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