RE: Question regarding IVIG

[Mazza, Kathleen]

I use peripherals for these patients - even when access is poor (I do mostly peds IVIG - typically with immune problems, ports not ideal) - I would recommend making sure the patient is really well hydrated when the infusion is scheduled. Drinking a few 16 oz. beverages in the hours before infusion can make a huge difference if the patient can tolerate it. Also - I never use anything larger than a 24G catheter - It will deliver the prescribed therapy over the required time, so I see no reason to use larger - this also makes it easier to get a tough stick

 

Kathleen Mazza, RN, MBA, CRNI
Director of Infusion Therapy
St. Vincent Catholic Medical Center CHHA, New York

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-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Marilyn Hanchett
Sent: Thursday, September 14, 2006 12:26 PM
To: Roger Soriano; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: RE: Question regarding IVIG

Probably not. You need to determine  the potential for peripheral access. Over 80% of our home IVIG patients use PIVs. They simply don't want to deal with a device that is noticeable under their clothing, requires maintenance and/or restricts any of their activities. We only tend to see PICCs when (1) the expected duration of therapy has not yet been fully established & response to treatment is still under eval (2) as an interim measure when PIVs are no longer practical and patient is being evaluated for port.

 

Additional Considerations:

 

Bear in mind that traditional thinking re infusing IVIG peripherally is to use an 18 or 20 gauge catheter. Not necessary. Decide if a 22 or 24 will work in this situation - and everybody be MUCH happier long term!

 

If this is an immune deficient patient, physicians are now no longer recommending ports. If peripheral access is not an option, consider subcutaneous.

 

 

Marilyn Hanchett RN

IgG America

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From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Roger Soriano
Sent: Thursday, September 14, 2006 12:07 AM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Question regarding IVIG

I have a patient who has a PICC inserted for poor IV access, but now needs IVIG infusions... I have a very limited experience with this drug.  The MD says the plan is to discharge the pt and have IVIG infusions once a month for at least six months...

Question is.. I know that the PICC is ideal for this infusion, but is it worth it to leave the PICC for once a month access just with daily flushing or remove it before discharge?  The catheter is Arrow 4Fr.

Any Thoughts... thanks

--
Roger Soriano, RN
Vascular Access Specialists
818-687-8348

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