Reply To: Chemo via IV straight set vs. buretrol

  • Kristie Schulz

    April 16, 2014 at 4:07 pm

    See answers below

    Kristie Schulz
    Cardinal Glennon Children’s Hospital
    Waterloo, IL
    United States

    Original Message:
    Sent: 04-16-2014 03:58 PM
    From: Mary Lynn Rae
    Subject: Chemo via IV straight set vs. buretrol

    This message has been cross posted to the following Discussions: Pediatric Chemotherapy Biotherapy Instructors and Nurse Educators .

    For those of you that infuse chemotherapy via straight sets a few questions (there is currently a nationwide back-order of buretrols for Carefusion/Alaris):
    1. Do you prime your straight set with saline?  YES
    2. If you do prime the straight set with saline what do you do for slow infusions? If the priming volume of our set is 25 mL/hour and the chemo infusion was going at 10 mL/hour it would take 2.5 hours for the 1st drop to hit the patient.. YES WE ARE AWARE OF THIS BUT FAST PRIMING IS NOT A PREDICATABLE PROCESS EITHER AND THIS MAY GIVE THE PATIENT A BOLUS OR YOU MAY LOSE MEDICATION.
    3. Does your pharmacy ever prime the tubing with chemo for you? If so under what circumstances (i.e. a certain rate/hour)? NO STAFF PRIME THE LINE WITH SALINE
    4. Do you fast prime the saline if necessary? and if so what is your rate limit (i.e. all drips < or = to 25 mL/hour)? Example:  RNs (x2) would set the pump rate to 999 for 25 mL (priming volume of tubing) to let the saline go in fast and then the same 2 RNs would set the ordered chemotherapy rate/hour (both RNs not allowed to leave until the rates are changed). 
    5. If you do use a fast prime have you seen an increase in errors?


    Mary Lynn Rae
    Ann & Robert Lurie Children’s Hospital
    Chicago, IL
    United States