Vanco infiltration

[Autym Didsbury]

Hi all-   I am coming to the group for a couple of suggestions.  We continue to get tremendous pressure from physicians to give peripheral vancomycin, phenergan, and other potentially dangerous meds.  In addition, the "powers that be" at our agency are not supportive either- we are basically told to take whatever is referred for fear of "alienating referral sources."  (Yes, I know)  To further complicate the situation, I am not getting a lot of support from my infusion pharmacy either- they are GREAT, but complacent with the issue of peripherals despite the potential risk.  Our "risk management" person is not a clinician, and doesn't grasp the implications at all.   What I am looking for is any references specifc to vanco infiltration and potential complications, as well as information regarding treating various extravasations.  Any suggestions would be greatly appreciated.  The concept of appropriate vascular access planning has not gained much ground in this community, and I am hoping that it doesn't take a disaster to get everyone's attention.     Thanks as always-    Autym Didsbury, RN, BSN, CRNI Home Health Manager Partners in Home Care 2687 Palmer St. Suite B Missoula, MT  59808 (406) 327-3717  Fax 327-3727