Looking for best practice guidelines for TPA infusions for stroke. Currently we use buretrols, draw up the dosage with a syringe and add the correct amount to the buretrol. Then we connect back into the buretrol to prime the IV tubing so we do not loose any solution and use the LVP to infuse the dosage. Thoughts for a better practice? I can not see any literature or minibag recommendations?
My advise would be to get rid of the buretrol. With nurses preparing this you are not in compliance with the USP 797, unless this is always used ONLY in emergency situations.
Buretrols are not good because they can not be correctly labeled when the medication is infusing versus when it is not infusing through the metered chamber.
Pharmacy should be preparing all IV medications under laminar air flow workbench. This would mean it is added to a bag of IV fluids and infused via an infusion pump.
Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank-you for your information. I agree we should not be using buretrols, but has been a difficult battle at my hospital. The nurses mix the TPA at bedside in ER and give emergently for stoke guidelines, our KOL at the hospital feels it is safer and more accurate using a buretrol for correct dosage.