Reply To: Methotrexate infusion

  • Cara Johnson

    February 7, 2020 at 2:53 pm

      This has been an issue at every hospital I have worked at and I have worked at 7 different large pediatric oncology units. What is working for us is increasing the rate starting at 3 hours before the end. This has been an issue for the past 20 plus years due to the large volume and pumps. So much they change the protocols to allow the MTX to end in 26 hours vs 24. Pumps are more sensitive now also so there is a delay. We run til dry because our RX takes pictures of hand injecting drug. Alaris pumps has an average 8% inaccuracy rate. 

    Search MTX or Methotrexate and I am sure you will see several threads 🙂 Good luck!

    Cara Johnson RNIII, BSN, CPON®
    Clinical Manager
    Hematology/Oncology Inpatient
    Cincinnati Childrens Hospital
    Work: (513)803-0306
    Cell: (513) 490-9253
    Original Message:
    Sent: 02-07-2020 05:57 AM
    From: Loucine Kaplanian
    Subject: Methotrexate infusion

    Dear Members,
    Please, it is highly appreciated if you provide us feedback on the following inquiries:

    We are facing problems with accuracy in the chemotherapy infusion volume, especially methotrexate. Are you facing issues with chemotherapy bags? When the infusion time of the chemotherapy is over while the chemotherapy bag is still full? Note that we know that all bags could have an additional 10% or minus 10% volume. However, the remaining amount that we are having left after the infusion is over is more than 10%.
    Do you run the remaining amount ? or you only run the volume and the rate you initially set on the of the pump?

    Loucine Kaplanian, RN