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7longpedhemeonc
chemotherapy infusions via buretrol in central and peripheral lines
Our current practice for administering both intermittent and continous infusions of chemotherapy in pediatric patients via central and perpiheral IV's is to begin by infusing the first 25 mL of iv fluid at fast rate on pump to prime line so that chemotherapy is at end of iv tubing and starting directly at the patient at specified time.  Rate is set to deliver drug over specified time and a 25 ml flush is given to clear all drug from the line.   Are there any pediatric heme/onc units that use the buretrol for delivery of chemotherapy and how do they address priming fluid and flushing after drug has infused?  Any thoughts would be appreciated.
Barbara Tinsley
Barbara Tinsley RN BS

Barbara Tinsley RN BS Presbyterian/St Lukes Hospital Bone Marrow Transplant

I work adult BMT, but we use buretrols for all our chemo.  We start with compatable IV fluid, NS/D5W 250 cc bag and flush buretrol and line with that.  Hook that up to patient then attatch chemo to top of buretrol.  when chemo is done, we add an appropriate amount of flush to the buretrol from that initial compatable IV bag.

Barbara Tinsley

lynncrni
My only concern about this

My only concern about this method is that the nurse sets it up, starts the infusion and leaves the patient. This is of great importance when giving a vesicant medication over a few minutes. I have always remained at the bedside aspirating for a blood return during the entire infusion or injection. Also use of a metered fluid chamber requires that the nurse transfer the drug into this chamber, thus increasing the risk of spilled or leaking drug and contact with it. I would prefer that the pharmacy compound and deliver all chemotherapy in the fluid container from which it will be infused so this bedside transfer can be eliminated.  

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Barbara Tinsley
Lynn,  Our pharmacy does

Lynn,  Our pharmacy does compound all chemo.  The chemo is then attatched as a piggy back into the buretrol.  The Connection at the top of the burretrol is taped.  Our chemo patients are 1:1 or done in our infusion center on our BMT unit so that someone is alwys in attendance and able to consistantly check for blood return.

Barbara Tinsley

lynncrni
Great, but that is not the

Great, but that is not the customary method for using a metered solution container. I have only seen the medication arrive in a syringe and then must be transferred to the metered container - not great for any drug but especially for chemo. Lynn 

 

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., 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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