Due to the inability to get Regitine, we recently changed our policy to Terbutaline for extravasation of vasopressors into a peripheral IV. Our facility is a rural hospital so we ship patients who need vasopressors and/or mechanical ventilation for an extended period of time. Being a rural hospital, however, we do have limited resources for placement of central lines, so we infuse vasopressors into peripheral IVs frequently. It is rare that we have vasopressor extravasation.
Anita Schrad Director of Critical Care & Orthopedics [cid:[email protected]] St. Anthony Regional Hospital 311 South Clark Street, Carroll, IA 51401 Office Phone (712)794-5569 [email protected]<mailto:[email protected]> From: Sepsisgroups [mailto:[email protected]] On Behalf Of Clifford Peebles Sent: Thursday, December 03, 2015 4:17 PM To: '[email protected]' Subject: Re: [Sepsis Groups] Administrative contraindications to care I was told by our pharmacist that Regitine is no longer available in case of extravasation of peripherally administered pressors. Just a quick search, and I found this statement: http://www.ashp.org/menu/DrugShortages/DrugsNoLongerAvailable/Bulletin.aspx?Source=NotAvailable&Type=Rss&Id=349 Has anyone else heard about this? Cliff From: Sepsisgroups [mailto:[email protected]] On Behalf Of Dustin Pierce Sent: Wednesday, December 02, 2015 9:24 AM To: 'Baker, Patricia'; 'Andre Vovan'; Mary Draper Cc: [email protected]<mailto:[email protected]>; Kelli Barrieau Subject: Re: [Sepsis Groups] Administrative contraindications to care I shared this article with a few others a couple weeks ago. It is an analysis of adverse events related to vasopressor administration through a peripheral IV. Thanks, Dustin Pierce, BSN, RN, CPHQ | Quality Outcomes Coordinator | Sepsis & VTE Coordinator | Quality & Safety The University of Kansas Hospital Phone 913-588-4819| [email protected]<mailto:[email protected]> 3901 Rainbow Blvd. Kansas City, Kansas 66160 “Things turn out the best, for the people who make the best of the way things turn out.” – John Wooden From: Sepsisgroups [mailto:[email protected]] On Behalf Of Baker, Patricia Sent: Tuesday, December 01, 2015 4:48 AM To: 'Andre Vovan'; Mary Draper Cc: Kelli Barrieau; [email protected]<mailto:[email protected]> Subject: Re: [Sepsis Groups] Administrative contraindications to care To my understanding, the refusal of a central line is not an exclusion. Although I completely agree that it should and to my mind, same as an exclusion to limiting resuscitation related to vasopressors. Just my thoughts. Pat Patricia A Baker MS RN CNS CCRN CCNS Critical Care Clinical Nurse Specialist Heart & Vascular Winchester Medical Center 1840 Amherst Street Winchester, VA 22601 540-536-6679 [email protected]<mailto:[email protected]> [cid:[email protected]] From: Sepsisgroups [mailto:[email protected]] On Behalf Of Andre Vovan Sent: Tuesday, November 24, 2015 12:38 PM To: Mary Draper Cc: [email protected]<mailto:[email protected]>; Kelli Barrieau Subject: Re: [Sepsis Groups] Administrative contraindications to care It only makes sense that this counts as an exclusion. Andre Vovan MD MBA Chief of Critical Care Hoag Memorial Hospital Prebyterian Andre Vovan, MD, MBA President/CEO Newport Critical Care, Inc On Thu, Nov 19, 2015 at 11:29 AM, Mary Draper <[email protected]<mailto:[email protected]>> wrote: Great question. I have had this same scenario and haven’t been clear on how to address it. Mary Draper RN BSN CCRN Coordinator Quality Improvement Peer Review Support CV/CT Quality Management Office (925) 674-2045<tel:%28925%29%20674-2045> Cell (925) 451-8792<tel:%28925%29%20451-8792> Fax (925) 674-2373<tel:%28925%29%20674-2373> [email protected]<mailto:[email protected]> [cid:[email protected]] “O, let us always have a mountain within our soul, with a peak so high that we never quite reach the top… For then we will always strive for greater things And will not be content with merely climbing hills.” Ardath Rodale From: Sepsisgroups [mailto:[email protected]<mailto:[email protected]>] On Behalf Of Kelli Barrieau Sent: Wednesday, November 18, 2015 12:55 PM To: [email protected]<mailto:[email protected]> Subject: [Sepsis Groups] Administrative contraindications to care We had a patient in septic shock who refused to have a central line placed. Without the central line, we were not able to give them vasopressors. The provider documented the conversation with the patient and family about refusing the central line and what it would mean but none of those are exclusions as an administrative contraindication to care. Does anyone if refusing any of the care would be a contraindication or is it just IV, antibiotics or blood draws? Thank you, Kelli A Barrieau RN BSN Unit Based Quality Nurse Cooley Dickinson Hospital PO Box 5001, 30 Locust Street Northampton, MA 01060-5001 413-582-2859<tel:413-582-2859> [email protected]<mailto:[email protected]> Cooley-dickinson.org Please note that the information contained in this message and any files transmitted with it are privileged and confidential and are protected from disclosure under the law, including the Health Insurance Portability and Accountability Act (HIPAA). 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