Reply To: Infusion Center Reaction Response Protocols

  • Theresa Gerten

    August 31, 2022 at 1:38 pm

    We at Phoenix Children’s Hospital also provide non-hemonc infusions to all subspecialties in our outpatient infusion center. We have created an algorithm to follow when any patient decompensates. We have an outside call provider (who is peds hemonc) who responds when any patient decompensates and calls their primary provider as needed. Our Infusion Nurse Leader may also contact the provider to inform of changes. However, our on-call provider who is present in our clinic guides our management. We also have a protocol for transferring patients to ED when initial interventions are not effective. We have recently hired an NP to provide this coverage for infusions who will begin in November. This NP has a broader experience than peds hemonc. If you have additional questions please feel free to email me directly. Thank you.

    Theresa Gerten, RN MSN Ed, CCRN
    Clinical Education Specialist
    Phoenix Children’s Hospital
    Phoenix, Arizona
    Original Message:
    Sent: 08-31-2022 11:23 AM
    From: Kaye Schmidt
    Subject: Infusion Center Reaction Response Protocols

    We have this scenario in our smaller satellite hospital setting.  We have been encouraged to call a Code if we cannot reach the ordering provider immediately and the patient needs rapid intervention.  We did work closely with our ICU physician to create standardized anaphylaxis protocols and we have standing orders in all of these non-hem-onc infusion patient’s order sets for when this occurs.


    Kaye Schmidt, MA, RN, CPHON, NEA-BC
    Senior Director
    Pauline Allen Gill Center for Cancer & Blood Disorders

    C: 214-686-5044

    1935 Medical District Drive | Mailstop B6.404  | Dallas, TX 75235

    Follow Children’s Health     





    Original Message:
    Sent: 8/31/2022 12:19:00 PM
    From: Chelsi Jentsch
    Subject: Infusion Center Reaction Response Protocols

    Hi all,

    I’m seeking insight on how other institutions manage any reactions that occur with Non-Hem/Onc infusion patients.

    At Rainbow Babies and Children’s Hospital, our Hem/Onc clinic serves also as the organization’s pediatric infusion center for other subspecialties (e.g., GI, Rheumatology, Endocrine, AAI, Neurology). Any Non-Hem/Onc patients are referred to us by their specialist as a nurse visit. Those providers are present in our clinic, but they are elsewhere within the hospital. The only providers in our clinic are Peds Hem/Onc.

    When a reaction occurs within our clinic with our Non-Hem/Onc patients, our Hem/Onc providers serve as the first responders while we attempt to get in touch with the patient’s specialist. We do not have any standards around expected response time, so it’s been very difficult to get them to come see their patients. Even when providers do come up to see their patients, their involvement is minimal.

    I’m curious what other infusions sites are doing. Although we are ambulatory, we are an OH space. Do you utilize hospitalists? Do you have a provider responsible to respond/attend to Non-Hem/Onc patients?

    Any insight is helpful.

    Thank you!

    Chelsi Jentsch, MSN, MHSA, RN, CPHON
    Nurse Manager – Outpatient
    Rainbow Babies & Children’s Hospital
    Cleveland, OH
    United States