Sounds like basic chemistry to me, but I to would like a reference to show this, as I have been making an ongoing case against Dilantin for some time now here at my facility.
Thanks Kathy
 
Heather Nichols RN BSN CRNI
Infusion Services
University of Louisville Trauma Institute
530 S. Jackson St.
Lou. Ky. 40202
(502)562-3530

>>> "Lynn Hadaway" <[EMAIL PROTECTED]> 02/06/06 9:42 AM >>>
Kathy, I must ask for your reference for this information. Please
provide it or tell us where you are getting this concept. Thanks, Lynn

At 7:09 PM -0700 2/5/06, Kokotis, Kathy wrote:
>Dilantin is in some ways not even compatible with normal saline or
>your bloodstream
>
>Normal saline pH 5.5
>Bloodstream pH 7.35
>dilantin pH 12-14 but if it falls  below 10 it precipitates.  Both
>blood and normal saline make the pH fall below 10 so therefore you
>will find crystals of dilantin in the lungs if it does not
>preceipitate sooner.  Are we not lucky the lungs are a great filter
>of life
>
>Kathy
>
>________________________________
>
>From: [EMAIL PROTECTED] on behalf of Leigh Ann Bowe-geddes
>Sent: Sat 2/4/2006 6:34 AM
>To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]
>Subject: Re: Dilantin
>
>
>Nancy:
>Dilantin is very prone to precipitation. It is not compatible with
>anything except NS. Flushing is very important, but there is another
>issue. The lumen through which the dilantin is infused should be
>dedicated to dilantin and NS only. Some of the drug may cling to the
>internal lumen, and if anything other than NS is infused between
>dilantin doses, you get dilantin crystals in the line.
>There are some other issues with dilantin. It is very important to
>flush well, and to administer the medication properly. It is not
>stable if the pH is allowed to drop, and the normal pH of dilantin
>is very high, somewhere in the 12-13 range.
>Leigh Ann
>
>Leigh Ann Bowe-Geddes, RN, CRNI
>IV Therapy Specialist
>Infusion Services Department
>University of Louisville Hospital
>Louisville, KY
>502-562-3530
>
>>>>  "Nancy Sullivan" <[EMAIL PROTECTED]> 02/03/06 8:26 PM >>>
>
>I know you ladies and gentlmen have probably discussed this many
>times, but I'm new to these message baords and have a  questions.
>
>My hospital has a policy that states: "DO NOT INFUSE DILANTIN THRU
>PICC LINES." I have been working at this hospital for 3 years and it
>does seem like every time a nurse puts dilantin into a
>picc--occlusion and loss of the line.  I have been told that it is a
>flushing problem and lack of education. We use groshong  and per q
>cath piccs. SO PLEASE EDUCATE ME IN THIS MATTER, BECAUSE I WOULD
>LOVE TO EDUCATE THE REST OF THE STAFF.
>Thanks in advance
>Nancy Sullivan RN
>
>
>________________________________
>
>Yahoo! Mail
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>
>
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--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861


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This message, including any attachments, is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law, including PHI (Protected Health Information) covered under the Health Insurance Portability and Accountability Act (HIPAA) of 1996.  If you are not the intended recipient(s), you are notified that the dissemination, distribution, or copying of this message is strictly prohibited.  If you receive this message in error, or are not the named recipient(s), please notify the sender or contact the University of Louisville Health Care I.S. helpdesk at 502.562.3637 to report an inadvertently received message.

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