We are transitioning to the Vesco brand of Enfit syringes in our health system and would like some insight into what other hospitals have done. Specifically, these are some questions:

We don't use mannitol very often, but when we do there seems to always be confusion with the dosing. We carry the 20% 500mL bags and often the dose is a partial bag. So, they would have to know what volume to infuse and set that in the pump. In very small writing it says "Each 100mL contains 20g", but when they are in a hurry they don't seem to see that text. Has anyone added an auxiliary label to these bags stating that "each bag contains 100g/500mL and to set the pump to the volume ordered" or something like that? Just wondering how to make it easier for them.

Hello all,

We are facing challenges with home care coverage for our patients on outpatient mesna and fluid infusions after chemotherapy in the ambulatory setting. In some cases, we have been forced to admit patients for the infusions previously done at home, due to the lack of home care companies willing to provide the medications and infusion pumps.

Hello,

I hope all are well. I'm reaching out to inquire about what you do at your respective institutions regarding Anesthesia and competencies for compounding. Our anesthesia staff prepare of alot of nerve blocks, and several with multiple medications in the syringes (including additive line clonidine, dexamethasone, or epi).

How do you guys do this?

Jameika Stuckey
University of Mississippi Medical Center

Is anyone using criteria to determine who should receive tranexamic acid for surgery? Would you be willing to share? Also, is this a checklist in your EHR (we use Epic) to screen patients when ordering? Thank you!

Has anyone adopted nrFit?

We utilize Pyxis Anesthesia for medication storage in the OR suite. We have received a request from Anesthesia to allow them to store succinylcholine outside of the Pyxis for the purposes being prepared to treat laryngospasm citing the reason that they cannot take the time to type in the drug name to access when a patient is crashing. Has anyone run into this legitimate concern and what are you doing to address this, keeping medication safe storage in place.

Looking for any advice/tips for handling of compounded levodopa/carbidopa oral suspension (already have the recipe) in terms of orderability for the ambulatory setting. It appears that our system is set up to handle levodopa/carbidopa in terms of "tablets" so dose checking and ordering for fractions of the tablet size become problematic.

Hello,

I was curious is others would be willing to share their process for physician ordering of parenteral chemotherapy and pharmacist order entry/verification, particularly if your EMR is Cerner.

Our process is currently to have orders entered electronically by the provider as a communication order (free text) and the pharmacists transcribes each order, a second pharmacist completes an independent double check prior to compounding. We are currently assessing this practice.

Thank you for your help!

Hello,

I wanted to reach out to see what your IM max volumes are at your institution. We have adjusted to 5mL for deep IM. However, we have seen where some institutions allow for 10 mL and even up to 30 mL (e.g. Fosphenytoin IM).

We are working to standardize administration and develop a tip sheet regarding IM Magnesium Sulfate. We are trying to decide if it should be 5 or 10 mL as that would determine the number of injections received by the patient (4 vs 2 respectively). Also considering adding Lidocaine to reduce pain as well.

Would love to hear back.