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
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
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
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
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.