Plast Reconstr Surg Glob Open. Preventing and managing vesicant chemotherapy extravasations Use a central venous catheter or implanted device for continuous vesicant infusions or for any vesicant infusion lasting longer than 30 minutes. 2141 0 obj <>stream 5200 Butler Pike The https:// ensures that you are connecting to the Adams DZ, Little A, Vinsant C, Khandelwal S. The midline catheter: A clinical review. Question:Will administering vinCRIStine in a minibag increase the risk of extravasation? 833 S. Wood St., Suite B12, College of Pharmacy, (MC 886), Chicago, IL 60612, 2023 The Board of Trustees of the University of Illinois, UI Health is UICs academic health enterprise. David V, Christou N, Etienne P, et al. Chemotherapy and Biotherapy Guidelines and Recommendations for Practice. Answer:For those patients who do not have a PICC or central venous access device, a peripheral IV line can still be used to administer vinCRIStine in a minibag. 2018 Apr 19;6(4):e1743. Clinical exam may reveal warmth, erythema, or tenderness. Gilbar PJ. 2013;1(1):9- 16. Innovative Oncology Nurses Break Down Communication Barriers for Patients Who Are Deaf or Hard of Hearing, How I Practice Mindfulness as an Oncology Nurse, Clinical and Pharmaceutical Nurse Educators Collaborate to Bring Training to Nurses and Improve Patient Care, Oncology Nurse Uses Retirement to Help Patients and Healthcare Professionals Understand Pancreatic Cancer Biomarker Testing Results, The Life of Marie Curie and Her Contributions to Oncology, FDA Reports Efficacy Issue for Patients Taking Pembrolizumab or Atezolizumab as Monotherapy to Treat Urothelial Cancer with Low Expression of PD-L1, B. Braun Recalls Certain Lots of Blood Administration Sets, FDA Approves Sunitinib Malate for Adjuvant Treatment of Renal Cell Carcinoma, News, Views, and Advocacy From the Oncology Nursing Society, Copyright 2023 Oncology Nursing Society, ONSs Chemotherapy and Biotherapy Guidelines and Recommendations for Practice, ONS and American Society of Clinical Oncology standards, Chemotherapy and Biotherapy Guidelines and Recommendations for Practice. Firas Y Kreidieh, Hiba A Moukadem, and Nagi S El Saghir. Pittsburg, PA: Oncology Nursing Society; 2014. The complexity of administration of antineoplastic agents and the potential safety issues involved are unique to oncology care and require careful consideration. Nurgat Z, Smythe MP, Aljedai A. Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. General recommendations for midline administration: A. Intermountain Medical Center . References: 1. However, the INS Task Force identified limited literature describing extravasation of vancomycin. %%EOF doi: 10.4081/pr.2012.e28. Pittsburg, PA: Oncology Nursing Society; 2014. Unable to load your collection due to an error, Unable to load your delegates due to an error. Clinicians considering drug administration via this VAD should review the chemical properties of the drug under consideration from reputable resources (eg, prescribing information) to compare them with the guidance above. 3 0 obj Watch for signs of extravasation; stay with the patient and verify blood return every 5 to 10 minutes. Apply cold pack intermittently for 15 minutes at a time, four times per day for 3 days, Apply cold pack 15 to 20 minutes at a time for at least four times per day for 24 hours. Your IP: hbbd```b`` "_HR, Iejw\Xo b&mQs8DbCC ; UN vR7. J Oncol Pharm Pract. Chemotherapy and Biotherapy Guidelines and Recommendations for Practice. Do not pinch the IV administration tubing because this can cause the vein to rupture. PMC Some references primarily classify drugs as vesicants or irritants, so those categories will preferentially be used below over classifying as inflammitants and exfoliants. Copyright 2023 Oncology Nursing Society. Unauthorized use of these marks is strictly prohibited. Chemotherapy and Biotherapy Guidelines and Recommendations for Practice. MeSH 2006 Nov 27;33(6):1134-41. doi: 10.1188/06.ONF.1134-1141. References: 1. Potassium Chloride. Eur J Oncol Nurs. The ASCO/ONS Chemotherapy Administration Safety Standards are intended to reduce the risk of error when providing adult patients with chemotherapy, and to provide a framework for best practices in cancer care. Also, dilution of the vinca alkaloid likely reduces the impact of any extravasation that might occur. ACR manual on contrast media. ONS is committed to promoting excellence in oncology nursing and the transformation of cancer care. %PDF-1.6 % 2008 Mar;13(3):284-8. doi: 10.1634/theoncologist.2007-0191. Determinations regarding the administration of drugs via midline catheter should consider properties of each drug individually because no definitive guidance is available to list the appropriateness of all drugs. Cloudflare Ray ID: 7c0b26d1e9b36bd5 5-Safe administration of anti-cancer drugs | eviQ Properties of midline catheters Rev. 6. Avoiding the use of infusion pumps for vesicant administration via short infusion using a peripheral vein (Polovich et al., 2009) www2.ons.org/ClinicalResources/Vincristine/Safety Antidote and treatment recommendations of vesicant chemotherapy manufacturers, antidotes and treatments approved by the U.S. Food and Drug Administration (FDA), and guidelines and . 6 Although the "extremes" are not further defined, the guidelines specifically recommend central lines for parenteral nutrition formulas . 2012;18(suppl):16-7. The main consideration in determining whether a drug is appropriate for administration via midline catheter is its propensity for causing phlebitis.2Phlebitis is inflammation of a vein caused by damage to the tunica intima, which may be accompanied by erythema, swelling, pain, heat, and a palpable cord if thrombosis is present. In 2021 the Infusion Nurses Society (INS) updated their 2016 guidelines and recommended consideration of midline catheters when the anticipated duration of therapy was 5 to 14 days with a preference for peripheral catheters for shorter durations of therapy and CVCs when longer durations of therapy are required.6 A recent study supports use of midline catheters for prolonged courses of therapy up to 14 days, but there remains limited data for use of midline catheters beyond 2 weeks.7 Currently, the CDC recommends consideration of midline catheters when the duration of IV therapy is likely to exceed 6 days.1,8, Considerations for drugs administered via midline catheter Careers. ONS is committed to promoting excellence in oncology nursing and the transformation of cancer care. 0 Patients often seek explanations for why their extravasations occurred. Cold (different suggestions depending on reference): Heat (different suggestions depending on reference): Cold - for 6 to 12 hours after administration of sodium thiosulfate. The loss of drug in the tubing exceeds the 5% dose variability acceptable for our chemotherapy doses per our hospital policy. Always obtain/ review MD order sent with delivery, identify patient with 2 identifiers. 139.59.111.99 Epub 2014 Jul 3. If not clearly defined in the literature. Irritant: Medication that can cause local inflammatory reactions at the infusion site, which may include: burning, swelling, pain, inflammation, tightness, or phlebitis. Answer:According to a publication by the Oncology Nursing Society, 1 the easiest way to check for a blood return is to use gravity by lowering the minibag below the IV site. Pittsburg, PA: Oncology Nursing Society; 2014. However, data suggests that the risk of extravasation is low, regardless of the method used to administer the drug. In addition, whenever an extravasation occurs or is suspected, vesicant administration must immediately cease, and the appropriate antidote or treatment needs to be promptly administered. The Oncology Nursing Society (ONS) is a professional association that represents 100,000 nurses and is the professional home to more than 35,000 members. Your institution can use them to inform practice policies and procedures, internal quality assessment, and external quality monitoring. Management of extravasation injuries: a focused evaluation of noncytotoxic medications. Federal government websites often end in .gov or .mil. 2.13.2 Vesicant chemotherapy administered through a peripheral intravenous must be infused IV push as ordered or via a short-term gravity intravenous line. The https:// ensures that you are connecting to the A description of the ASCO/ONS Chemotherapy Administration Safety Standards process for development, consensus, and refinement, as well as a discussion of the standards and results, is available on theASCO website.
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