We have had an increase frequency of complaints with the initial infusion of Penicillin G for Group B strep mothers who are starting labor. The complaints are for burning and infiltration. What is the policy of this infusion at your facilities and what is the best way to deliver this medication without harming the patient's veins?
Thanks!
Follow all recommendations in the Infusion Nursing Standards of Practice for
1. catheter selection - smaller is always better than a larger gauge
2. site selection - avoid all areas of joint flexion
3. adequate catheter stabilization with an engineered stabilization device. Tape and dressing is not sufficient
4. medication administration - proper dilution, rate of infusion, etc. This drug is know for causing thrombophlebitis
5. prevention of infiltration is paramount, also in the standards of practice
I am in the final stages of updating our online CE course on infiltration and extravasation, should be ready in about a week.
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
Molly,
As Lynn mentioned, one of the most important points in a Laboring mom is location of her IV. I have seen many PIV's in laboring mom's placed in compromising positions...i.e. hand, wrist by the L&D nurse because they were the easiest access. In our high risk perinatal acute care setting, a standard order is in place for LR to infuse as a primary infusate. This is also for the case for prehydration on an epidural placement or for fluid resuscitation. If you have a primary infusion, I would recommend titrating the PCN G dose lower to slow the rate so that it can be diluted. Our Perinatologist aren't particular about the infusion time, as they are in wanting to get at least 2 doses in prior to delivery. Hope this helps!!