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tjack
Lidocaine/BARD?
Have recently been informed that BARD is having trouble with the packaging of lidocaine in their tray, and that it will no longer be included in their packaging until they can get the issue resolved. If any of the experts have any factual information please shed some light on this topic. Thanks!
lynncrni
I don't know the details of

I don't know the details of this issue with Bard, but can tell you that putting a medication such as Lidocaine in a sterile tray changes the way it is processed and makes a difference in the expiration date for the package. There are numerous ways that something could happen to this process. And many reasons why some manufactures do not place these vials in any tray.  

 

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

Paul L. Blackburn
Thought I should offer a
Thought I should offer a little more information on the Bard lidocaine issue.  Recently, Bard became aware of an import law that affected Bard's ability to import kits into the US that contained prescription drugs.  Simply put, Bard's lidocaine supplier is based in the US.  This supplier shipped lidocaine to Bard's packaging plant in Mexico.  Bard then packaged the kit, including the lidocaine, and imported the completed kits back into the US for sterilization and sale.  This obscure import law prevents a prescription drug supplier from shipping drugs out of the country and having a second US based manufacturer ship the drug back in country.  I suppose this law is in place to slow down the illegal trafficing of controlled substances across the border.  In any case, rather than hold up 1000s of PICC kits, Bard chose to build the kits without lidocaine.  This is a temporary situation as Bard works through the legalities of this law with the FDA and border patrol.  Fortunatley, Bard had enough warning about this issue that supplies of Bard PICC kits without lidocaine have been built and will not cause back order.  Additionally, any Bard PICC kits that currently exist on customer's shelves are usable.  This issue has only affected Bard's full procedure trays, and again is temporary.  I suspect no longer than 60 days.  Interestingly, most US based PICC manufacturers build their kits outside of the US and many use the same lidocaine supplier that Bard has used.  It is therefore possible that other PICC manufacturers will begin experiencing this same issue.  As soon as Bard finds a solution to this problem, lidocaine will begin appearing within Bard PICC kits once again.  In the meantime, if you need further information or if I can be of assistance, please email me directly at [email protected].
lynncrni
Thanks for the information.

Thanks for the information. Just one more hurdle in the process to deal with and a new one on me.  

 

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

Michelle E Moody
I have checked with our

I have checked with our supplier of our piccs, Medcomp, and they have assured me that all their kits that have any drugs/pharmaceuticals in them are made and packaged in the good ole' USA!  Medcomp kits will not have this problem and there are no back order lidocaine issues with them. 

 

MEM

IV TEAM LEAD

Memphis, TN

IVRN
I have checked with our
I have checked with our supplier, Arrow Intl.  All of their PICCs, including their power PICCs are packaged in the USA, no problems with this Pedigree law or packaging medications in the PICC kits. 
mary ann ferrannini
Just saw my first kit
Just saw my first kit without it. It was a 6Fr Power PICC.
tjack
Doesn't seem very user
Doesn't seem very user friendly?
Timothy L Creamer
As vascular access

As vascular access specialist's we should use this Lidocaine issue to reevaluate our patient needs. Our facility is in the process of switching to buffered Lidocaine for patient comfort and receiving PICC trays without Lidocaine is not significant. Anyone working in an acute care facility can request this from the pharmacy, it expires in 7 days however any waste should be minimal. The patient deserves any comfort measures available and buffered Lidocaine does not burn.

Timothy L. Creamer, RN

Clinical Specialist, Bard Access Systems

tjack
Would acquiring from
Would acquiring from pharmacy etc. bring up sterile field issues? Typically vials from pharm. are not sterile, therefore can't simply drop onto sterile field.
Timothy L Creamer
Do not "drop" Lidocaine vial
Do not "drop" Lidocaine vial on sterile field. Set it nearby and leave alcohol pad used for cleansing on top. Use a one handed sterile glove technique to fill syringe once ready to tighten tourniquet. Then either change gloves or remove outer pair if using double glove technique. Hope this helps.

Timothy L. Creamer, RN

Clinical Specialist, Bard Access Systems

momdogz
Use one lido vial per

Use one lido vial per patient, and if you can - have a second person help (preferable) by holding vial with disinfected top, or do one sterile handed technique if you don't have a second person. 

I MOST prefer to use lidocaine packaged in the kit because no matter how careful you are, it just adds one more step that can potentially contaminate sterile procedure without your awareness, but the above method will work.  Some of our more staff previously used this technique for years and our infection rates have been very low.

I used to use the above technique because I wanted to use buffered lidocaine, but I've since changed my mind because of the same principle - adding another step and potential contamination.

Mari Cordes, BS RN 

Nurse Educator IV Therapy
Fletcher Allen Health Care, Burlington VT
Educator, Bard Access Systems 

Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

RAllen
I am so spoiled!  I have a
I am so spoiled!  I have a tech that helps me set up trays, holds the lidocaine etc. (As well as a rad tech always with me).  Having help like this really makes the insertion faster as well as lowering the risk of contamination.  I used to do all this by myself so I will never take this for granted. A one handed technique is definitely not the way to go, but If you are by yourself you got to do what you have to do.
SaraF
I made arrangements with the
I made arrangements with the pharmacy and sterile processing to sterilize the vials so that we can drop them on trays for now. 
afruitloop
FYI:  Be careful at

FYI:  Be careful at re-sterilizing vials of solutions.  I  don't know a whole lot about it, but yes it is very easy to do, but there are regualtions, safety issues, etc with doing this.  If it were just that easy, then manafacturers would not have the grief that they do when trying to get solutions, etc into sterile kits.

Lynn, do you know anything about this? 

Cheryl Kelley RN BSN, VA-BC

lynncrni
When I read this message I

When I read this message I had similar thoughts and concerns about in-house sterilization of theses medication vials. I do not know enough to provide any good information. At the least, I would check with the pharmacy and the drug manufacturer for their recommendations about this. Questions I have would be - are there any changes in the integrity of the vial from the sterilization process being used? are there changes in the drug itself from the process? what processes are acceptable? I would want to know about temperature and pressure, etc.  

 

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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