Reply To: Desensitization

  • Pamela Dockx

    Member
    October 7, 2022 at 12:23 pm

    Here at Boston Children’s, we are reworking our policy to be able to do desensitizations of chemotherapeutic agents in the inpatient unit after successful first desensitization in our Intermediate care program.

    We have successfully managed many desenses over the past 2 years. Key factors include allergy team approval, overnight hospitalist coverage (comfortable with the plans) as well as 1:1 continuous nursing observation of the patient.

    This has eliminated the need for one of our nurses to be off the unit for the length of the infusion and also less disruptive for the patient/family.

     

     

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    Original Message:
    Sent: 10/7/2022 12:01:00 PM
    From: Mary Lynn Rae
    Subject: RE: Desensitization

    We do one in the PICU per allergy recommendations and if all goes well then can be on the unit; however we also do asparaginase desensitization right from the start in our infusion center

     

    Thanks,

    Mary Lynn

    Mary Lynn Rae, MSN, RN, NPD-BC, CPHON, BMTCN

    Nursing Professional Development (NPD) Practitioner/Clinical Educator

    Pronouns: she/her/hers

    Center for Cancer and Blood Disorders (LC17/LC18)

    Ann & Robert H. Lurie Children’s Hospital of Chicago

    T 312.227.4224 | mlrae@luriechildrens.org | luriechildrens.org

    225 East Chicago Avenue, Box 248, Chicago, Illinois 60611-2991

     

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    Original Message:
    Sent: 10/6/2022 4:19:00 PM
    From: Ryan Profetto
    Subject: Desensitization

    Hi all,

    It seems like this question has been asked in the past, but I would love to get some more current answers than were on the previous threads. When we identify the need for a patient to get a chemo desensitization, their initial dose is given in the PICU, but 2 Heme/Onc RNs are required to hang each bag and depending on the agent: flush and take down the bag (sometimes the protocol calls for up to 4 bags) which is very resource intensive and leaves the floor short for a considerable amount of time. 

    My question is, if a patient receives a successful first desensitization in the ICU, do any institutions perform subsequent desensitization protocols on the heme/onc unit? Is there a certain number of “successful” desensitizations that must be done before considering moving them to the floor? And what ratios do you staff the patient in… 2:1, 1:1? Just looking to benchmark what other institutions are doing so we can try to optimize our resource utilization. 

    Thanks,
    Ryan​

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    Ryan Profetto, BSN, RN, CPHON, BMTCN
    Clinical Nurse II
    UCSF Benioff Children’s Hospital
    Pediatric Hematology/Oncology/Blood and Marrow Transplant
    San Francisco, CA
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