Hello,

How does your institution comply with fosphenytoin IV Push administration on the nursing units with regards to NIOSH classification of a hazardous drug.
1. Do you compound the IV Push dosage form in the IV room and send to nurse or
2. do you send vials and allow nurse to draw up in the unit using a CTSD?

We have had some reports of wrong volume preparation for doxorubicin 2 mg/ml IVP syringes caught prior to patient administration. We utilize EPIC's split dose functionality, which includes both the total volume and package volume on the syringe label. Have others had similar reports of incorrect volume in each package? If this is not a problem with your institution, would you be willing to share an example of your split dose doxorubicin label to assist us in improving?

How does your hospital manage the use of sugammadex for patients in emergency situations when intubation and ventilations are unexpectedly difficult or impossible, requiring sugammadex administration in 16 mg/kg for NMBA reversal?

Where is the total reversal dose kept? Crash cart, anesthesia cart, or kit?

Thanks

Hi
I would like to know how your sites ensure patients are ventilated prior to starting propofol/fentanyl/midazolam/paralytics infusions? We use Epic and would like to know if there is a system enhancement to not allow ordering or verification or dispensing of sedation meds to non -ventilated patients?

Thank you
Pratixa Patel

We currently utilize Veri-Link (Rudolph Research Analytical) refractometer in our diversion monitoring program.

Reaching out to inquire if there is any known pooled RI Drug Index reference documents.

Trying to identify found unlabeled syringe contents - wanted to know if any one had knowledge of shared reference document and/ or had in their refs document any medication with a specific RI of our unknown sample reading = 1.33242

Thank you,
Michelle

We have experienced a recent uptick in amiodarone extravasations. We currently do not require central line for administration. Hoping to get a few responses on whether or not central access is required at any institutions. Or other safety mechanisms in place to improve safety of administration via peripheral access. We do have a handful of ivWatch devices but likely not enough to cover all patients receiving amiodarone infusions.

Hello all,

We usually try to find good stability indicating studies (like stability indicating HPLC studies) to extend our compounded preparations (still within USP 797 BUD limit). For some reason we are unable to find anything other that stability studies according to measured PH and co2 levels...does anyone know if this is considered sufficient? if so, why? wouldn't this be only potency indicating, but stability indicating? I appreciate your help!

Thanks!

Hi everyone,

Our pediatric hospital has an epidural order set that has standard concentrations of each ingredient (we use ropivicaine or bupivicaine +/- clonidine +/- fentanyl/ hydromorphone). The dose field in Epic is mL/hr.

A new MDA expressed that dosing in mL/hr is difficult, and they prefer to dose in mg/kg/hr or mg/hr. We are unsure how this would work with multiple ingredients, each of which has a standard concentration.

How does your facility dose epidurals?

Thank you!

Hi,

We are in the process of expanding our Epic/Alaris interoperability as much as possible. Right now, ED, PACU, and OR are out of scope. We have a plan to go live in the ED, but we were wondering if anyone uses interoperability in the OR/with anesthesia?
Our anesthesia team uses OpTime and one-step meds, so I'm not sure if that is something we can overcome or not.

If anyone has figured this out, I'd love to hear about your processes!

Thank you,
Kara Thornton
UVA Health
krp4h@uvahealth.org