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joscott
Midline catheter, suitable drug administation.

We have had numerous problems with IV Amiodarone and less with dopamine being given peripherally.  Physicians are very reluctant to insert CVP lines and we are looking at midline catheters as a solution for these infusions and for long-term antibiotic use (6-8 weeks) for Endocarditis patients who cannot have skin tunnelled lines inserted due to cardiac devices.  However I keep reading that guidelines suggest drugs with a PH less than 5 or greater than 9 should not be used.  Amiodarone and dopamine have a PH of 3.5-4.5.  Can anyone help with any advice of lines that they use or know of that could be used for these drugs?

thank you

jo

lynncrni
You are correct - neither of
You are correct - neither of these drugs not the 6-8 weeks of antibiotics would be appropriate for a midline. A PICC is the catheter of choice. Lynn

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

afruitloop
I have been able to

I have been able to identify amiodarone with a high incidence of phlebitis and thrombosis.  The problem at my facility was that the drug was not used for more than a few days and the doctor did not want to place a CVC or a PICC.  It definitely was a problem.

You will certainly have to gather your literature on pH, irritaiting drugs, INS guidelines, best praoctices, etc to present to him.  I am sure your education department, risk management and nursing professional council will support you with this.  Good luck!

Cheryl Kelley RN BSN, VA-BC

kokotis
Kathy Kokotis Bard Access

Kathy Kokotis

Bard Access Systems

Maybe your pharmacist should pick up their own guidebook called Trissels.  They buy a new one every year as it is updated yearly.  Trissels states what the manufacuturer recommends "central line administration only" for cardaraone.  Got ot Trissels. 

 

Kathy Kokotis

Bard Access Systems

Peter Marino
Is that a complete/direct

Is that a complete/direct quote? I found "concentrations greater than 2 mg/mL should be administered via a central line" Which is it?

 

[quote=kokotis]

Kathy Kokotis

Bard Access Systems

Trissels states what the manufacuturer recommends "central line administration only" for cardaraone. [/quote]

Peter Marino R.N. BSN CRNI VA-BC Hospital based staff R.N. with no affiliation to any product or health care company.

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