I have a question in need of input from this group. I know what my practice was but can't find much in print addressing this issue. If you are giving Adriamycin as a 30 minute infusion piggybacked into NS and connected to an implanted port, do you leave the patient alone during that infusion or do you remain with the patient that entire time? How frequently do you aspirate for a blood return during the infusion? Lynn
Our policy for every vesicant is to check for blood return every five minutes with vesicant administration. Personally, I stay with the patient for the entire infusion, and treat the infusion as a 30 minute push via pump. I only help out in our chemo infusion room a couple of times a year for vacations etc. I am sure this comes up, have you checked the ONS boards?
Kathleen
Thanks, that is what I have done in the past and would continue to do and teach. 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
The Oncology Nursing Society has in their standards specifics for PIV administration of short infusion vesicants (gravity flow, check blood return q 5-10 min, stay with the pt), but does not have the same recommendations for central VAD administration. This is what the standard says in their newest guidelines for vesicants via CVAD:
1) Verify blood return prior to, during, and after drug administration
2) Monitor the IV site throughout the infusion according to institutional policy
3) Discontinue vesicant administration at the first sign of extravasation
Doesn't address gravity flow vs pump administration; doesn't give a time frame for checking blood return. Does say "monitor . . . throughout the infusion"; however this wording is distincly different from "stay with the pt" used for PIV. May be subject to interpretation.
If blood return is verified and the patient can cooperate (lie fairly still, not be up to the bathroom or rolling around in the bed), I think staying in the room may be overkill during the infusion. But this is why many nurses prefer to IV Push vesicants as it keeps them close to the patient during infusion.