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Portacath with dilantin occlusion

I need a reference to create a policy for Na Bicarb instillation to treat a dilantin precipitae. I have the new INS standards in front of me but the refences refer to tpa, ethanol and HCL.

Christine Thomas
I have only seen this in the

I have only seen this in the Oncology Nursing Standards.


Chris Thomas

Do you have that standard?

Do you have that standard?

The articles referenced in

The articles referenced in Standard 56, Practice Criteria F provide you with a discussion of alteration of pH by using either Na Bicarb or hydorchloric acid. These discussions are based in basic chemistry. Phenytoin has a pH of 11-12 or highly alkaline. Precipiate occurs because that high pH has dropped. To reverse the precipitate, you raise the pH with bicarb. I don't think you will find any actual clinical studies reporting the outcomes of the use of each solution. Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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