My pharmacist sent an email to me explaining that OB physician is noting that Pit infusions are causing pain during infusions because it is too cold. He suggests that the Pit should be mixed on the unit and not have to be cold.
Pharmacy states that guidelines prohibit this. The pharmacist asked me if there were any long term effects on the veins with the infusion of cold infusions. I can only find hypothermia side effects.
Does anyone know the answer to her question? Has anyone that works OB experienced this complaint of pain with the cold infusions and how do you deal with it?
I would appreciate any response. OB is not my field. Thank you,
Chris Thomas
I was an OB nurse for 16 years and I've never had a problem with this happening. So the bags of Pitocin that are being sent up from pharmacy have been refrigerated? I would suggest hooking up an IV fluid warmer from the O.R. We used to mix our own Pit bags, but due to new guidelines this is now prohibited.
Ann Armstrong, RN
PICC Lines
MidMichigan Medical Center, Midland
Are you saying Pitocin is compounded into fluid containers in the Pharmacy and then refrigerated, then hung to the patient directly from the refrigerator without any period of time to elevate the temperture? All cold fluids infused into the vein have the ability to cause venospasm due to excitation of the smooth muscle of the tunica media. I have seen patients complain of this cramping type of pain at the infusion site when giving blood which is taken directly from the blood bank refrigerator where it is held around 5 degrees C. Parental nutrition is taken from the refrigeration for a period before it is hung so it can get to room temperature. What size catheter are they using in these patients? I would bet it is a large one, consuming most of the internal vein lumen and reducing normal blood flow around this catheter and reducing hemodilution of the cold pitocin infusion. Why is the compounded pitocin going directly from the refrigerator to the vein without being closer to room temperature before hanging it? I am not sure, but I doubt that this is a stability issue. Solution closer to room temperature and/or placing a warm compress over the infusion site to relieve this venospasm would be the ways to manage it. Compounding by nurses on the unit outside of a Class 5 laminar airflow work bench would NOT be the best thing to do due to the risks of contamination. 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