Hello everyone,

I would love to know what other facilities have in place for administering lipid resuscitation therapy for LAST.

At my facility, we have a panel built for a bolus of 1.5 mL/kg/dose followed by an infusion of 0.25-0.5 mL/kg/min.

However, if you calculate the dose for a 65kg patient, the rates are as follows for a 20% lipid solution:
- Bolus ends up being 5850 mL/hr
- infusion ends up being 0-1950 mL/hr

Does any one have an insulin pen policy that they are willing to share?

Does anyone compound this and have a recipe? This seems to be the reference.

Thanks!

The use of tetracycline is based on this article: Perry, Julian D. M.D.*; Mehta, Viraj J. M.D., M.B.A.†; Costin, Bryan R. M.D.*. Intralesional Tetracycline Injection for Treatment of Lower Eyelid Festoons: A Preliminary Report. Ophthalmic Plastic and Reconstructive Surgery 31(1):p 50-52, January/February 2015. | DOI: 10.1097/IOP.0000000000000173

Please share if your organization's pharmacy dispenses any specific IV infusion medications with IV priming and/or IV tubing/filter attachment.

Reaching out to see what pumps others put on their helicopters?

I have an ambulatory surgical center looking to create protocols for management of hypoglycemia and hyperglycemia in the surgical setting. Does anyone have protocols in place that you'd be willing to share as an example or references to direct us to as a starting point. We've researched UpToDate and CDC and are looking for additional guidance if possible. Given the ambulatory setting, there is no pump, so an insulin drip would not be used.

Hello everyone. I'm wondering how everyone is meeting the DNV standard (QM section SR.4s) that requires monitoring of quality indicators for safe opioid practices. We have tried to utilize the CMS 506 metric but it bounces around a lot and there aren't any established benchmarks that I can find. Is anybody using this metric or an alternative metric to meet this DNV requirement?

Hello, does your institution restrict 20gm magnesium sulfate orders to certain units? Or are there any alerts in place for doses greater than a particular threshold?

We recently had a near miss with 20 grams magnesium sulfate and I am trying to identify system based strategies to safeguard the orders.

Appreciate your input!

Have any organizations implemented automatically discontinuing held orders after a certain timeframe in the EMR

Recently we have been getting push back from laboratory in regard to holding heparin drip for 15 minutes to obtain an Anti-Xa/aPTT lab due to preventing a "contaminated" specimen. I wanted to see if anyone else:

- holds heparin infusions for lab draw
- If there are any concrete studies that support not having to hold the heparin drip/flushing the line and only holding for 1-2 minutes.

I am concerned that we have been getting inaccurate results if lab has been pausing for 15 minutes. Thank you!