I have no experience in peds or the E.D. so I need your help to get our ED nurses up to speed on this. The question is can one run more than 1 antibiotic at the same time. They understand the compatibility and vesicant aspects as well as first dose protocols. I also understand from experience an anaphylactic reaction can occur during any subsequent dose. Pharmacy is only looking at compatibility. My question is running more than 1 at a time would make reaction difficult to pinpoint the drug causing it and in situations where someone is septic, time is of the utmost essence in survival rate. Is there any guidelines or literature out there regarding this? I have searched all of my INS references. Thanks!
Valorie Dunn, RN, BSN, CRNI
I think this depends upon what drugs you are talking about. I can't remember any examples, but there are therapeutic issues for some combinations if infused too closely together. So pharmacy should be assessing physical, chemical, and therapeutic compatability. In the past, I have even seen some acceptable combinations in the same fluid container, but again, this depends upon the specific drugs being infused. The other issue is the difficulty in determining which one is causing any adverse reaction including allergy but there are others. I am wondering if there is any therapeutic benefit of infusing multiple ABX simulataneously rather than consecutively. Again, this would be a drug-specific decision based on drug-specific research. I don't think you can have a blanket policy that would be applicable to all IV ABX in all situations. 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, That was kind of my thought. Too many variables to look at and weigh the pros and cons when trying to save a life. They are looking for very specific guidelines I figured were not out there but needed the opinion of one with much more experience:)
Valorie Dunn,BSN, RN, CRNI, PLNC