Reply To: Infusion Center Reaction Response Protocols

  • Raeanne Beglin

    August 31, 2022 at 2:42 pm
    We have a designated provider each day in clinic/infusion called DOD (doc of the day). They are responsible for the patients in infusion that are RN only visits (no scheduled PEs). They would response for reactions, to obtain blood consent etc. We also have a CIP (caregiver Initiated protocol) for anaphylaxis with standard doing for IM epi based on the pt’s weight. 

    Lynea Beglin, RN BSN CPHON
    Clinical Educator
    SR Aflac Clinic and Day Hospital

    Original Message:
    Sent: 8/31/2022 12:24:00 PM
    From: Kaye Schmidt
    Subject: RE: 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

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    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