Is the pH and osmolarity chart up to date? I ask because on that chart, it gives the recommendation for PIV or CVAD for each medication, and I'm not sure that is the case since the change in the guidelines. Also, valium isn't even on there and it's way out of range on osmo.
Sheila
Not sure which version you are asking about. l think this original table was published in JAVA or JVAD many many years ago and the pharmacist who did it has no plans to update it.
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
Shiela,
Are you talking about this site. I think it is also managed by Kevin. If so I don't think it has been updated for some time. I like that it could be a working reference.
Craig
http://www.ivaccess.com/
C. Craig Farris BS,RN, CRNI
The problem I have with that site is there is no information about the type and volume of diluent. You can not figure osmolarity without that information, so where is this coming from?
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
There is a need to have an easy-to-use reference without calling the pharmacy or searching through general computer based lists . Kevin Arnold (administrator for this site) added the reference list ot IVACCESS.com and perhaps it can be updated. pH and Osmolality are important to all of us and our patients when we look at what device to recommend or place for X number days/weeks. Vein condition /status / abuse / age are all big considerations when planning for catheter tip positions and long term infusions. Patient tolerance to chemical infusions is individual and tip related. Benefit vs burden or risk vs benefit is a daily thought process in our work.
Scott Gilbert, RN MPH (Honolulu)
Scott, I agree there is a need. But it has to be complete, accurate, and maintained up-to-date. That takes lots of time to create and maintain. Is this a service you would pay to access? If not, then it looks like everyone will have to find this information for each drug as needed from their pharmacy.
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 only updated / added to the list when users have submitted them. Yes, ph/osml is only one piece of the decision process per new guidelines. Concerning the data, they are the the most common ph's / osml's from a very reputable online drug book (for the ones I listed). (and as you noted Lynn, osml can not be known in specifics.... the data posted is what the drug book listed as common... i believe the infusion nurses using this resource understand that concept). If the meds were submitted by others, I included their reference and any notes in the pop up link. I agree calling the pharmacy can be a great resource but they often do not know the ph... it's not an achievable goal in some facilities.
Kevin Arnold, MSN, BBA, BS, BSN, RN
Web Manager, www.iv-therapy.net
A few years ago I made a chart based on our own hospital formulary, it was a huge undertaking. We used it and I have shared it, (even made an AVA poster with it) but the pH and osmo are based on OUR pharmacy. Happy to share, but know your infusates may not match mine.
JIll, great points. Each pharmacy may use different types and volume of diluent so that will change the osmolarity. Lynn
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