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We have had the same concerns for children <10kg. What we ultimately decided was to dilute VCR in 20mL minibag primed through a secondary set. Then we used a Phaseal “Y” tubing attaching the secondary set to one side and a saline syringe to the other for blood return checks and flushing. This kept the total volume to about 30mL. See below. Hope this helps!
—————————— Kathleen Morris, BSN,RN Nurse Leader University of Rochester Rochester, NY United States ——————————
——————————————- Original Message: Sent: 05-21-2015 11:03 AM From: William Copeck Subject: Vincristine— again
We have switchd over to minibags and while the strain on resources is significantly higher, overall it seems to work fine. Including priming the line, med, and flush we are talking 65-75 ml of fluid total infused.
Our docs have one concern: In patients 10kg and less they feel quite strongly that 65-75 ml is too much volume to give. Extending the infusion time is not an option. We are not staffed for it and when multiple meds ar being given, time contraints come into play.
Is anyone else handling smaller kids and infants differently than the others?
Our docs would like to do these kids in a 20 ml syringe to limit the volume (our syringe tubing holds 1 ml so we are talking 21-22 ml total). Pharmacy is not totally comfortable with this as they feel it defeats the purpose but we feel it is a reasonable and safe way to address the concern.
—————————— William Copeck, BSN,RN,CPHON Bloomfield, NJ United States ——————————