Anyone using buffered Lidocaine with their PICC placements? If so are your pharmacists compounding it for you or can it be purchased? Any feedback would be greatly appreciated.
Marty Quinton, CRNI
I had a conversation with Eric Kastango, RPh and expert on USP 797 about this very issue just a few days ago. If a nurse mixes buffered lidocaine outside of a laminar ariflow workbench, the entire volume must be used or discarded within 1 hour. If mixed in the pharmacy under a laminar airflow workbench meeting the requirements of USP 797, it is considered to be in the mediam risk category. The beyond use dates are 30 hours if stored at room temp or 9 days if refrigerated. This just speaks to solution sterility and stability. Mixing is not so easy also because precipitate can form.
The other issue is that these vials are intended for multiple uses on multiple patients - a fact that is opposition to all regulatory agencies and recommendations from professional organizations including APIC, CDC, INS, Joint Commission, ISMP, etc. I know buffered lidocaine causes less pain to the patient, but it could also create significant risk for transmission of infection if not managed correctly. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Office Phone 770-358-7861
Our pharmacy mixes these in 1ml syringes as needed. We seem to have just as good results with LMX4% topical plus Lidocaine 1% subQ.
Rose Feltner RN, BSN, CRNI
Speciality Practice Nurse
Vascular Access Team
Indiana University Hospital Bloomington[email protected]
We obtain premixed 5 ml syringes of 1% buffered lidocaine from Ameri-dose (www.ameridose.com) We then transfer it to a sterile syringe on our field using a luer-lock to luer-lock devise.
We also get 1 ml syringes of buffered 1% lidocaine for our peripheral IV's
For our pedatric patients the pharmacy prefills 1 mL syringes for us. Theresa