How is everyone handling the shortage of regitine? >Our institution is proceeding with a change: Dopamine must be given >through a central line. In an emergency, start a peripheral, however a >central line must be inserted within 90 mins. until regitine is >available. The thinking is that this will not make us liable in the case of infiltration of dopamine.
Comments please.
Jan
Congratulations! Your facility is now meeting the standard of care for infusion of dopamine as this drug is a known vesicant and should always be infused through a CVAD. You do have a significant misconception though. Use of a CVAD for vesicants will reduce but not eliminate the risk of extravasation. Remember this drug is a vesicant so this is extravasation not infiltration. There is still a risk of extravasation with any CVAD and infusion of any drug. It can occur from many causes such as a complete fibrin sheath allowing retrograde infusion, malposition catheter tip, erosion of the catheter tip through the vessel wall, etc. Your liabllity is still present and would only be mitigated if there is adequate document of correct periodic site assessment which includes the presence of a blood return that is the color and consistency of whole blood, the total absence of any complaints of all discomfort, and the absence of any problems with manual injection (resistance) or occlusion alarms on the pump. So the nurses can not think that the CVAD is going to relieve them of the responsibility to do this site assessment and that they have no liability if a problem develops. It can still happen with a CVAD, but a CVAD is thought to be a more reliable catheter and reduce the risk. But nothing can totally eliminate the risk! Please take this message to all your staff! Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thanks Lynn, will disseminate this info.
Jan