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marcia erickson
Central venous administration of potent medication
Of late we have had some significant extravasations.  It is unfortunate but it has brought home the importance of requiring certain solutions be delivered centrally.  Both risk managaement and medical staff have asked that I design a policy.  Has anyone a policy they could share?  What would be an appropriate time frame to require central venous access, 12 hours, 24 hours?  Which medications or solutions would you have on your list?  I have my ideas, what are yours.  Thanks, Marcia
lynncrni
The list of medications

The list of medications should be specific to the formulary used in your hospital. All medications with a pH less than 5 or greater than 9 and those with final osmolarity greater than 600 mOsm/L should go through a central venous catheter. All vesicant meds should also go through a central venous catheter. A list from another hospital may not be approrpiate because those drugs may not be on your hospital formulary. 

 I am not sure what you mean about the time frame question. When therapy will be longer than 6 days, a PICC is indicated according to the CDC guidelines. 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

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