at one time lido was supplied in the picc kit itself but is no longer provided. The company i was working for had to order vials of lidocaine. Our company in MA no longer uses lido because it is not considered to be all inclusive when a picc order is written and the thought thrown around is we should require an order for the use of lido. We now use saline making a wheal at the insertion site which seems to be just as effective as the use of lido provided the nick prior to introducer insertion is done carefully. I find it to be 6 of one or half dozen of another. No complaints of burning from lido insertion and a little more facial grimacing with saline but, all in all patients have been responding well.
You and all the readers might enjoy reading the article in JIN Nov/Dec 2010 entitled, Administration of Local Anesthetic Agents (Anderson, Cockrell, Beller, Murphys, Nelson, Hawkins, and Cederna-Moss).
Your original question was about buffered lidocaine. This means that sodium bicarbonate must be added to the vial of lidocaine, making this a compounded sterile prepration. Your pharmacy must meet the statements from USP 797 on how they supply this. It must be prepared under a laminar air flow situation and discarded according to the beyond-use date placed on the label. Lynn
For your buffered lido, do your facilities have any issues with the multidose vials?
Our deal is that our facility doesn't make buffered. We have had some additional training and realized the potential benefits. The thing is, for us, even if we could get them to make it, they don't allow multi-dose vials.
Does anyone have experience with this? I appreciate the insight.
There is always an issue with any multidose vial as there is plenty of evidence that they increase the risk of infection and cross contamination. So your policy on no multidose vials is a great one. Buffered lidocaine should be a patient specific or single dose vial prepared according to USP 797.
Our pharmacy orders single use syringes of Buffered Lidocaine, 5ml in a 10 ml syringe. Not sterile - we squirt it into our PICC tray and draw it up with the sterile syringe included on our kit. It does have a preservative (shelf life of about 4 weeks).
We used to use buffered Lidocaine prepared daily by our pharmacy in a multidose vial. Now our pharmacy supplies us with 5cc single-dose syringes from Ameridose out of Westborough, MA. According to our pharmacy, they are the only company who could guarantee them an expiration date of about 20 days, unrefrigerated.The syringes are not sterile. We transfer the content to a sterile, labeled syringe with the aid of a sterile Baxa luerlock to luerlock rapid fill connector (cost pennies).Works very well. I believe we also use their 2 cc syringes for painless IV starts throughout the house.
at one time lido was supplied in the picc kit itself but is no longer provided. The company i was working for had to order vials of lidocaine. Our company in MA no longer uses lido because it is not considered to be all inclusive when a picc order is written and the thought thrown around is we should require an order for the use of lido. We now use saline making a wheal at the insertion site which seems to be just as effective as the use of lido provided the nick prior to introducer insertion is done carefully. I find it to be 6 of one or half dozen of another. No complaints of burning from lido insertion and a little more facial grimacing with saline but, all in all patients have been responding well.
Karen
Well, thank you for sharing.
You and all the readers might enjoy reading the article in JIN Nov/Dec 2010 entitled, Administration of Local Anesthetic Agents (Anderson, Cockrell, Beller, Murphys, Nelson, Hawkins, and Cederna-Moss).
Kathleen Wilson, CRNI
Your original question was about buffered lidocaine. This means that sodium bicarbonate must be added to the vial of lidocaine, making this a compounded sterile prepration. Your pharmacy must meet the statements from USP 797 on how they supply this. It must be prepared under a laminar air flow situation and discarded according to the beyond-use date placed on the label. 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
For your buffered lido, do your facilities have any issues with the multidose vials?
Our deal is that our facility doesn't make buffered. We have had some additional training and realized the potential benefits. The thing is, for us, even if we could get them to make it, they don't allow multi-dose vials.
Does anyone have experience with this? I appreciate the insight.
Thanks!
Kathleen Wilson, CRNI
There is always an issue with any multidose vial as there is plenty of evidence that they increase the risk of infection and cross contamination. So your policy on no multidose vials is a great one. Buffered lidocaine should be a patient specific or single dose vial prepared according to USP 797.
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
Our pharmacy orders single use syringes of Buffered Lidocaine, 5ml in a 10 ml syringe. Not sterile - we squirt it into our PICC tray and draw it up with the sterile syringe included on our kit. It does have a preservative (shelf life of about 4 weeks).
Regards,
Judy Thompson
Thank you! Good to know!
Kathleen Wilson, CRNI
We used to use buffered Lidocaine prepared daily by our pharmacy in a multidose vial. Now our pharmacy supplies us with 5cc single-dose syringes from Ameridose out of Westborough, MA. According to our pharmacy, they are the only company who could guarantee them an expiration date of about 20 days, unrefrigerated.The syringes are not sterile. We transfer the content to a sterile, labeled syringe with the aid of a sterile Baxa luerlock to luerlock rapid fill connector (cost pennies).Works very well. I believe we also use their 2 cc syringes for painless IV starts throughout the house.