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I apologize for the late response. I work at St. Jude and we have developed a specialized formulary for Blina and received training. We never run anything with Blina– the patient should generally always have a dedicated lumen to use in order to infuse the drug. Secondly, if for any reason the infusion needed to be interrupted (cultures, blood backing up, end of the infusion etc), the guidelines state to remove exactly 5 mLs to discard (2 mLs of medication, and 3mLs of blood) in order to clear the BEFORE flushing. Because Blina runs at such a slow rate, it is imperative to ensure the line is clear of all medication before flushing, or else you will accidentally be giving a bolus on the medication, which could lead to serious implications.
I hope this helps, feel free to reach back out with any other guidelines questions,
—————————— Chelsea Conlee, RN —————————— ——————————————- Original Message: Sent: 10-25-2020 02:51 AM From: Melodi Thompson Subject: Blinatumomab
Hello! When we first started infusion Blin, we had the same problem. We ran NS @ 5 ml/hr concurrently with it while they were inpatient.
—————————— Melodi Thompson, RN Fort Worth, TX United States ——————————
Original Message: Sent: 10-22-2020 02:32 AM From: Makenzie Lewis Subject: Blinatumomab
We recently had a patient who came in for Blinatumomab infusion. Blood started backing up into the line about 4 hours into the infusion. We looked over the COG FAQs for this, however it didn’t give specifics as to how to clear the line.
Do any institutions out there have a solution? We couldn’t flush the line because patient was already showing signs of Cytokine Release Syndrome. We’ve only done 2 Blinatumomabs in the past 3 years here so have very little experience to go off of.
—————————— Makenzie Lewis, RN Durham, NC United States ——————————