Does anyone has experience of using norepinephrine infusion 200 mcg/mL concentration. Is there any reference for its stability? Secondly I am looking for information regarding the hemodynamic instability (drop in blood pressure) during syringe switchover in critical care areas, potential causes and solutions.

We periodically have issues with our batching labels coming off the refrigerated IVPBs. Our label size is 2 and 11/16" x 2." This happens more so after being sent via pneumatic tube, and has led to errors of mislabeled vasopressors (or uncertainty in what they actually are). Sometimes we have trouble with readability as well due to the ink rubbing off. We've tried ordering "fresh" labels (older ones tend to lose their stickiness it seems) and changing our printer ink/toner. Has anyone else experienced these issues? Have you discovered any fixes? Thanks.

Dear Colleague: The ISMP subsidiary, Med-ERRS, is looking for a few pharmacy directors or purchasing decision makers who will be attending the ASHP Summer Meeting in Denver, where they will be holding an advisory board meeting on Saturday evening. The board will focus on how certain products currently are prepared in the pharmacy, what the process is for including a new preparation on the formulary, who the key decision-makers are for this change, and how this change may impact pharmacy workflow.

Our institution has been utilizing a 503B Pharmacy for outsourcing prefilled Cefazolin Syringes. We have been experiencing great delays in receiving the medication and we’ve been reverting back and forth to mixing IVPB. I have been looking for a secondary supplier but had no luck finding a local pharmacy or any pharmacy that would ship the product. Any recommendations?
Regards,
Samar Abouelella

We are updating our patient education handout regarding hazardous medications, especially in the area of safely using long acting hazardous medications in the home (testosterone, Lupron/provera therapy etc). If you have an patient handout, would mind sharing this? Thank you!

Can anyone recommend a company that manufactures metric-only oral measuring devices (e.g. Oral syringes)?

Hello everyone,
Does anyone have a source for the new warning labels for this best practice? The warning was revised and now states "Warning: Paralyzing Agent-Causes Respiratory Arrest-Patient Must Be Ventilated." I didn't know if there was a place to purchase this as a sticker or is everyone making their own? Thanks!

Interested to hear how others are currently managing the storage and distribution of ViperSlide (by Cardiovascular Systems Inc) in their facilities. Is the product maintained by pharmacy or central supply? Also, would love to hear any other safeguards others have put in place. I thought this had been featured in an article by ISMP in 2012 but cannot seem to find the information.

Are other facilities adding medications to the product? If so, is it maintained on the MAR?

I appreciate any insight others are willing to share/provide. Thanks!

We are struggling with the shortage of Bupivacaine in dextrose for spinal anesthesia. What is your hospital using &/or what steps are you taking to make your Bupivacaine in dextrose for spinal anesthesia last?
Thank You!
Cathy Goetz
St. Luke's Hospital
cathy.goetz@stlukes-stl.com

Does any institution currently utilize nitrous oxide for non-neuraxial labor analgesia? If so, would you be willing to share:
1. A protocol or policy and procedure used to implement the program?
2. Vendors or manufacturers utilized for the blender and scavenger systems? At this point, I think we would be more interested in a portable system as opposed to having it piped through the wall.
3. Concentration utilized for the blend: 50/50 or other? Anyone using up to a 72/25 blend?