My institution is currently is currently conducting a gap analysis for pediatric continuous infusions in accordance to ASHP S4S recommendations. While conducting the analysis we have found a significant limiting factor in us trying to slim down the available concentrations are the extremely low weight NICU patients where we need dilutions so Alaris can administer. Our current practice is to dispense in either 30 or 50mL syringes to which Alaris has a minimal rate of 0.1mL/hr
We are working on submitting a practice change for our pediatric pharmacy to start dispensing continuous infusion in 3mL syringes for extremely low weight NICU and PICU patients. This will now allow us to have a minimum rate of 0.01mL/hr. I am hoping to obtain some data of what other institutions do for the proposal.
1.) Does your institution dispense continuous infusion medications in 3mL syringes?
2.) What issues or concerns have you ran into when dispensing in 3mL syringes? The pharmacy departments main concern is nursing mixing up continuous and intermittent doses leading to an IV push of a continuous infusion (of note, we currently do not have interoperability at this time)
3.) Have you been able to operationalize which syringe to use based on weight or do you allow the pharmacist to pick at verification?