Dilute 10 mg (10 mL) of milrinone in 40 mL of diluent or 20 mg (20 mL) of milrinone in 80 mL of diluent. The inotropes work to enlarge the vessels and help the heart contract harder. Push Run/Pause button on the current pump. Early hospital discharge has been associated with both fewer nosocomial infections and decreased financial burden. Your administering blood through a picc and the flow is decreased.Patient coughs, tubing kinked or some other external/internal force. Cardiologists have used it and milrinone to help a weakened heart pump more efficiently. An official website of the United States government. 21-2112: Includes Pump with yellow keypad for Regional Anesthesia, pump key, remote dose cord, 4 AA batteries, and 2-year limited warranty. Milrinone is given as an infusion into a vein, usually around-the-clock for up to 48 hours. Secure, discreet and worry-free. The https:// ensures that you are connecting to the low potassium level--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling. If you have any questions, contact a member of your healthcare team directly. Disconnect IV tubing from IV . The .gov means its official. 0000002248 00000 n A subgroup (n = 18) with severe cardiac pump dysfunction and three patients in This helps make sure the dose is accurate. [Rational and irrational approach to the inotropic agent therapy of heart failure]. . However, if the resident had used the All Drugs option available in anesthesia mode, he would have been able to access a milrinone infusion entry, which included preestablished low and high concentration limits. Your heart rate and blood pressure will be . Remove current Curlin Pump and Milrinone medication bag from pump bag. 0.75 mcg/kg/min. We have a patient on Milirone at home on a CADD continuous pump via a dual lumen PICC. The dose is 7.5ml/hr and the bag change is every other day. I have a pharmacist not wanting to send saline for line flushes due to the possiblity of bolusing the patient and then the patient being without the drug for the amount of time the milrinone goes through the catheter. I would like to know . The treatment of AHF exacts a great financial and manpower toll on the healthcare infrastructure. 0000000016 00000 n Whether you are at home, at work, or on-the-go, you can still receive the medication you need. 0000008738 00000 n When it is infused at home, Milrinone, which is an intravenous inodilator agent, reduces the number of hospitalizations. %%EOF Brozena SC, Twomey C, Goldberg LR, Desai SS, Drachman B, Kao A, Popjes E, Zimmer R, Jessup M. J Heart Lung Transplant. Consideration should be made for double checking infusion pump parameters when each infusion container is initiated . 7. Dilute 10 mg (10 mL) of milrinone in 40 mL of diluent or 20 mg (20 mL) of milrinone in 80 mL of diluent. 554 0 obj <> endobj The diluents that may be used are 0.45% Sodium Chloride Injection, USP; 0.9% Sodium Chloride Injection, USP; or 5% Dextrose Injection, USP. Less commonly ordered is "pulse therapy" which infuses the Inotrope medication over 24 to 48 hours a few times per week. Family burden. It's possible that your infusion will finish as early as 42 hours (6 hours before the time written) or as late as 50 hours (2 hours after the time written). Milrinone is a positive inotrope and vasodilator, with little chronotropic activity different in structure and mode of action from either the digitalis glycosides or catecholamines. HHS Vulnerability Disclosure, Help Clipboard, Search History, and several other advanced features are temporarily unavailable. Milrinone Mechanism : Milrinone is a positive inotrope and vasodilator, with little chronotropic activity different in structure and mode of action from either the digitalis glycosides or catecholamines. You must have JavaScript enabled to use this form. 0 Likes. Please enable it to take advantage of the complete set of features! Intravenous pain management with the following delivery methods individually or in combination with each other: The quality of life of patients with AHF also is reduced severely. An initiative was implemented to reduce these barriers, including: Providing educational programs such as anesthesia grand rounds, which included discussions about this event and hands on education about smart infusion pump capabilities (e.g., dose/concentration limits and warnings, bolus dose feature), Performing standardized competency assessments for the use of smart infusion pumps with an engaged drug library for all anesthesia residents, as well as anesthesia providers and other OR practitioners, Opening the lines of communication about future barriers to using smart infusion pumps so they can be addressed rather than result in unsafe practices (e.g., failing to engage the library), Reissuing a leadership-driven requirement to use smart infusion pumps with an engaged drug library in the OR. 0000013277 00000 n Milrinone also reduces left ventricular filling pressure in chronic heart failure patients. An ambulatory infusion pump is used to administer the medication as a continuous infusion into a vein. If you're a patient at MSK and you need to reach a provider after 5:00 p.m., during the weekend, or on a holiday, call 212-639-2000. Your home health nurse will teach you what you need to know about your Milrinone is given as a continuous infusion. 0000004269 00000 n for Healthcare professionals: MILRINONE LACTATE, Vials U.S. Latest treatment guidelines 1 assign continuous intravenous infusion of a positive inotrope agent for palliation in patients with refractory end-stage heart failure (HF), a class IIb indication. Careers. Milrinone lactate is available as sterile aqueous solutions of the lactate salt of milrinone for injection or infusion intravenously. The use of hard stops can serve as a forcing function and reduce the incidence of incorrect infusion pump programming. The table below shows the volume of diluent in milliliters (mL) that . Patient Teaching Guides for Infusion Therapy Services including Antibiotic, Catheter Maintenance, Chemotherapy, Desferal, Dopamine, Enteral Feeding, IGG, Pain Management and TPN. . Push On/Off button to turn current pump off. Milrinone :Classes: Inotropic AgentsPhosphodiesterase Enzyme Inhibitors.VasodialatorIndication :Short-term management of patients with acute decompensated he. Bethesda, MD 20894, Web Policies "qpipo7opqLzd8 zh(K"rdlG. . Premixed infusions are already diluted and ready to use. . Thursday, October 27, 2022. 3. BENEFITS. Milrinone lactate is available in Australia as Primacor, and comes in 10ml ampoules each containing 10mg of active ingredient. Disclaimer, National Library of Medicine Physician Prescribing Information. This video demonstrates how to prepare a milrinone setup and change the bag on an existing infusion in the home setting using the Curlin 6000 infusion pump. Highly skilled home nursing care is required in the treatment of patients. ISMP has contacted Hospira about the milrinone labeling problem, and the company is currently revising the label to present the concentration as the total amount of drug in the container per the total volume, following USP <7> standards. FOIA Last Updated. The home care nurse plays a major role in the outcome of a patient with AHF. Insulin Pumps. 449 Posts. An infusion pump is necessary to safely administer the drug . J Heart Lung Transplant. This video demonstrates how to prepare a milrinone setup and change the bag on an existing infusion in the home setting using the Curlin 6000 infusion pump. An insulin pump allows the replacement of slow-acting insulin for basal needs with a continuous infusion of rapid-acting insulin. 0000023590 00000 n Milrinone decreases the overall treatment costs of AHF. Increase in mortality. m2aB"p01Fx(`Zp8:"nR?NjU>\7nqd8V! 0000001773 00000 n Therefore, the use of milrinone injection in hypotensive patients should be considered carefully and therapy should be started with a low dose. hbbd``b`$ \`K 9i'H1# [ 5200 Butler Pike 0 This site needs JavaScript to work properly. 6. Administration and absorption. Hypotension. Due to the milrinone overdose, the patient required observation and supportive care in an intensive care unit but did not suffer serious adverse effects (e.g., cardiac arrhythmia, significant hypotension). Milrinone is used in patients with acute decompensated heart failure with reduced ejection fraction, as well as before and after cardiac surgery. Milrinone, at relevant inotropic and vasorelaxant concentrations, is a selective inhibitor of peak III cAMP phosphodiesterase isozyme in cardiac and vascular muscle. We have successfully migrated to our new eCommerce website and all systems are now live at www.preferredmedical.com . 202 0 obj <>stream Storage. PMC bobnurse. Safety Topic / Subject. 161 42 0000023970 00000 n Along with its inotropic properties, milrinone also causes peripheral vasodilation . This method of administration to patients allows for the exact volume of medication to be carefully monitored and controlled to guarantee patient safety. When creating the anesthesia drug library, implement upper and lower hard limits whenever possible for medication doses, concentrations, infusion rates, and loading and bolus doses (often different than hard limits for maintenance infusions) used in the OR. During investigation of the event, the resident felt as though the label on the Hospira premixed bag of milrinone also contributed to the error. Dec 10, 2008. %%EOF You will need a central line (CVC or PICC) for home infusions. By using an insulin pump, the patient can typically match the dosage of insulin to lifestyle and activities, rather than adjusting those to the body's . . Compatible diluents include 0.45% NaCl, 0.9% NaCl, and D5W. Physiologically, milrinone contributes to an increase in cardiac output but decreases pulmonary capillary wedge pressures and vascular resistance. hb```SlR ac`ahava`d(8`i7ET#:::0 . Minimize exposure to . Use of smart pumps that default to, or require programming within the drug library, can also improve safety in the OR. 8600 Rockville Pike This is very doable with excellent teaching,good family support anf an Infusion Company with 24 hour nursing on-call service. endstream endobj startxref Your infusion should finish close to the date and time written below. The typical dose range is between 0.1 to 0.75 mcg/kg/minute. 0000001158 00000 n Publication types 0000003706 00000 n 0000011543 00000 n You must be logged in to view and download this document. A 74-year-old man had a tachycardia of 145/minute during infusion of milrinone after an operation for repair of an abdominal aortic aneurysm [19].The tachycardia was controlled by esmolol on one occasion and more impressively by metoprolol on a second occasion. 0000010089 00000 n Since the pump did not alert him to the erroneously low concentration entry, the resident initiated the infusion. The resident was unfamiliar with the smart infusion pump available for use in the operating room (OR). Even my continuous milrinone patients disconnect. MILRINONE LACTATE, Flexible Plastic Container (Manufactured by Gland) U.S. Highly skilled home nursing care is required in the treatment of patients. The resident was using the pump in anesthesia mode. Milrinone was not listed in the anesthesia drug library because it was rarely used. 0000024202 00000 n 0000009975 00000 n This video demonstrates how to prepare a milrinone setup and change the bag on an existing infusion in the home setting using the Curlin 6000 infusion pump. I have given Milrinone in the home many times. infusion of a positive inotrope agent for palliation in patients with refractory end-stage heart failure (HF), a class IIb indication. Baseline characteristics were similar in the milrinone group and the dobutamine group ( Table 1 and S2). Milrinone infusion is one of a few select "non-device" therapies for patients with New York Heart Association (NYHA) class IV, stage D heart failure, which has been associated with an increase in ventricular tachyarrhythmia and atrial fibrillation. Administered as a continuous infusion, milrinone is indicated for the short-term treatment of patients with acute decompensated heart failure. 0000002635 00000 n 0000001449 00000 n Before 0000012284 00000 n This is not a complete list of side effects and others may occur. 0000010824 00000 n All rights reserved. 2007 Nov 3;151(44):2426-8. Has 15 years experience. In this case, the 100 mL bag of milrinone completely infused in a very short time, leading the anesthesia resident to realize that an error had been made. 0000027545 00000 n Milrinone belongs to a group of drugs called inotropes, which work by helping the heart pump more blood through the body. 2022 Institute for Safe Medication Practices. . 0000004935 00000 n The IV was left in. However, data regarding the choice of inotrope for these patients are lacking.2 Dobutamine and milrinone are the 2 most commonly used intravenous inotropes in the United States. Continuous infusion with a pump usually takes about 48 hours. The home care nurse plays a major role in the outcome of a patient with AHF. endstream endobj 555 0 obj <>/Metadata 42 0 R/OCProperties<>/OCGs[564 0 R]>>/Outlines 58 0 R/PageLayout/SinglePage/Pages 550 0 R/StructTreeRoot 83 0 R/Type/Catalog>> endobj 556 0 obj <>/Font<>/Properties<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 557 0 obj <>stream The pharmacy dispensed a 20 mg/ 100 mL (0.2 mg/mL) milrinone infusion bag. Medicare Part B (Medical Insurance) covers infusion pumps (and some medicines used in infusion pumps) if considered reasonable and necessary. Heart failure occurs when the heart can't pump . The Medicare home infusion therapy benefit is for coverage of home infusion therapy-associated professional services for certain drugs and biologicals administered intravenously, or subcutaneously through a pump that is an item of DME, effective January 1, 2021. 0000001627 00000 n Milrinone improves hemodynamics and provides symptomatic relief. 1.13 mg/kg. A prospective study of continuous intravenous milrinone therapy for status IB patients awaiting heart transplant at home. 0 Milrinone or Dobutamine are the two medications . Bookshelf Enables patient to go home Physician . ICH GCP. Anna Flaxis, BSN, RN. When given in the home setting, you and a willing caregiver who is living in the home, must learn how to manage the infusion (change the medication bag, troubleshoot the IV pump, and identify when a problem is occurring). To this end, we conducted a study to investigate . He then programmed the infusion pump to deliver the intended dose-rate of 0.25 mcg/kg/minute. Milrinone Home Infusion RISKS Catheter related bloodstream infections. Data will be collected over the 12-72 hours the patient will be receiving the milrinone infusion. There is no alarm to tell you this. In the hospital where this error occurred, the anesthesia department chair has taken the important step of understanding why smart infusion pumps with an engaged drug library were not being correctly used in the OR by some anesthesia providers, including residents. government site. As an aside, for this pump vendor, hard stops transitioned to soft stops in anesthesia mode, thereby allowing overrides of established dosing/concentration limits, even catastrophic limits. Our team arranges home health services and we ship necessary supplies and . Ned Tijdschr Geneeskd. Infusion rate (mL/hr) = (patient weight (kg) dose (microg/kg/min) 60) infusion strength (microg/mL). Administered as a continuous infusion, the reported adverse effects of milrinone include ventricular arrhythmias, hypotension, and headache. The pumps are locked in a level where the rate can not be changed. If there is excessive hypotension during milrinone therapy, the infusion should be stopped until the blood pressure returns to normal. Milrinone is a prescription medication used for short-term treatment of acute decompensated heart failure (a specific type of heart problem). He subsequently entered an incorrect milrinone concentration of 200 mcg in 100 mL, when the infusion bag he was hanging contained 20 mg in 100mL of 5% dextrose. Milrinone is a widely used positive inotropic agent in patients with end-stage heart failure and cardiogenic shock . Federal government websites often end in .gov or .mil. Includes yellow pump, pump key, remote dose cord, 4 AA batteries, and 2-year limited warranty. 0000007151 00000 n 0000023272 00000 n Milrinone, a new agent for the treatment of congestive heart failure. Milrinone titration timeframes are dependent on renal function and as tolerated by patients. 2004 Sep;23(9):1082-6. doi: 10.1016/j.healun.2003.08.017. Using the custom concentration option, a nurse set the concentration as 0.2 mg/100 mL. A one-year subscription grants you access to even more information! trailer PoppyPocket is the safe and easy way to transport your infusion pumps and other medical devices. Milrinone is a phosphodiesterase 3 inhibitor with both positive inotropic and vasodilator properties. This product information is intended only for residents of the United States. Milrinone IV was prescribed to infuse at 2.5 mg/hour. angiotensin II. Just think about it. Inotrope therapy is used for heart failure. Milrinone Infusion Using the Curlin 6000 Infusion Pump, Pediatric Home Service Expands To Serve Children Throughout The State of Iowa, The First Step to Making the Right Choice is Finding Answers, Tips and Tricks for Making Your Kiddos Comfortable During a Long Infusion, Life With A Child with Medical Complexities, Los videos disponibles con subttulos en espaol, Wichita, KS Home Care/Private Duty Nursing HQ . Institute for Safe MedicationPractices Would you like email updates of new search results? Medication Safety Officers Society (MSOS). Both of these actions help more blood to be pumped from the heart into the body. Milrinone can cause tachycardia, partly because of its vasodilatory effects and partly perhaps by a direct effect on the heart. For additional recommendations, please see the ISMP Guidelines for Optimizing Safe Implementation and Use of Smart Infusion Pumps. 0000003068 00000 n 0000003805 00000 n The typical dose range is between 0.1 to 0.75 mcg/kg/minute. You might get them continuously or periodically over 6 to 72 . MILRINONE LACTATE, Flexible Plastic Container U.S. If the patient is having a shower with the infusion running, then the pump is working on the battery and stays behind the shower curtain.We do have infusion caps we can use, but the question is which method gives more risks for the patient. A healthcare provider will give you this injection. 0000027944 00000 n After showing hemodynamic improvement with milrinone while hospitalized, central lines were placed and patients were given the drug at home with small portable infusion pumps, starting at 3 days a week for 6 hours at a time over a 3-month period. Thus, the resident mistakenly thought the bag contained a total of 200 mcg/100 mL. Kliniske forsgsregister. Also available in French, German, Dutch, Danish, Spanish, Swedish, Italian, Portuguese and Japanese. The total amount per total volume (20 mg/100 mL), which should be the most prominent concentration expression following the drug name, is instead listed on the label in smaller print above the blue background. 5. Dextrose, lactate and bicarbonate are present, acting to adjust the pH to a sour 3.2-4.0. Since the resident did not use milrinone frequently, he was unfamiliar with the Hospira packaging of the premixed infusion. MeSH [Infusion of inotropic agents at home in patients with severe heart failure: an important role for the nurse practitioner]. Call Us: Home Infusion / Enteral Nutrition: 1-800-755-4704 This is normal. 0000003594 00000 n 271. You can wear it discreetly in four different positions to engage in normal daily activities with no hassle. A SINGLE INFUSION PLATFORM FOR PAIN MANAGEMENT. 2007 May;26(5):453-7. doi: 10.1016/j.healun.2007.02.004. Infuse maintenance dose via continuous infusion pump. xref Concentration: 1 mg/mL. We are excited to offer our customers expanded products and services across the entire post-acute market. 0000004850 00000 n startxref The entire bag containing 20 mg infused in a matter of minutes instead of infusing over 8 hours. Compatible diluents include 0.45% NaCl, 0.9% NaCl, and D5W. Problem: An anesthesia resident wanted to start a milrinone infusion on a perioperative patient who required inotropic support. At sammenligne effektiviteten af Levosimendan versus Milrinone til at understtte hmodynamikken under off-pump koronar bypass-operation hos . 2 Dobutamine and milrinone are the 2 most commonly used intravenous inotropes in the United States. Accessibility official website and that any information you provide is encrypted It has been in use for almost two decades. Infusion rate guide: Maintenance continuous infusion rate for milrinone (mL/hr) (using 200 microg/mL solution). If the pump was programmed with an erroneously low milrinone concentration of 200 mcg in 100 mL, the drug would infuse at a rate of 600 mL per hour. The pH is . We created a video showcasing 4 of the popular infusion systems. 0000007293 00000 n The site is secure. We also recommend limiting the use of anesthesia mode in smart pumps that change hard limits to soft limits, to ensure that catastrophic limits produce a hard stop. 0000009396 00000 n The infusion pump fails to generate an audible alarm for a critical problem, such as an occlusion (e.g., clamped tubing) or the presence of air in the infusion tubing. Infusion therapy no longer requires hospitalization - oftentimes, it's possible anywhere. 8. Indication : Congestive cardiac failure; Cardiac surgery (post-operative, low output failure) Contraindications : After internal mammary artery harvest, milrinone 0.5 g.min -1 .kg -1 (29 patients) or a normal saline infusion (33 patients) was started and continued until all graft . 0000012133 00000 n Respiratory; Infusion; Nutrition; Infection Prevention; Life With A Child with Medical Complexities; Los videos disponibles con subttulos en espaol Premixed infusions are already diluted and ready to use. Re-Clamp the clamp on the IV line. Born premature and unable to absorb nutrients, JoeVon now has an appetite for life. Arrhythmias. 0000012843 00000 n These are covered as durable medical equipment (DME) that your doctor prescribes for use in your home. A total of 3 titrations may occur as tolerated over incremental timeframes of 4, 12, 18 and 24 hours. IMPORTANT NOTICE - WOLF IS NOW PREFERRED: Wolf Medical Supply is now officially part of Preferred Medical, An NDC Company. Milrinone decreases the overall treatment costs of AHF. Unfortunately, it is not a cure for patients suffering from heart failure, leaving many eligible for hospice care after the heart has deteriorated beyond repair and a heart transplant is not an option. Abstract Background: Milrinone infusion is one of a few select "non-device" therapies for patients with New York Heart Association (NYHA) class IV, stage D heart failure, which has been associated with an increase in ventricular tachyarrhythmia and atrial fibrillation. Includes Milrinone indications, dosage/administration, pharmacology, mechanism/onset/duration of action, half-life, dosage forms, interactions, warnings, adverse reactions, off-label uses and more. The mean (SD) age of patients was 68.913.8 years in the milrinone group and 72.011.3 . 563 0 obj <>/Filter/FlateDecode/ID[<35610C041280F8418E44D2A74A6752BE><8F1F74E79DE4C741800DF52D75E9177D>]/Index[554 23]/Info 553 0 R/Length 62/Prev 137879/Root 555 0 R/Size 577/Type/XRef/W[1 2 1]>>stream Thus, he entered the drug concentration and dose manually. The systemic and pulmonary arterial hemodynamics of 40 patients with severe congestive heart failure were determined during a 24-hour infusion of milrinone (0.5 micrograms/kg/min) after a loading dose of 50 micrograms/kg. 161 0 obj <> endobj %PDF-1.6 % 0000017782 00000 n Section 1861 (iii) (2) of the Act defines home infusion therapy to include the . However, data regarding the choice of inotrope for these patients are lacking. When the infusion ran at night, we used the same pump as that in the fanny pack." The PICC line was removed after one week if the patient remained stable off milrinone and tolerated therapeutic doses of beta-blockers and ACE inhibitors or an adrenergic receptor blocker (ARB) agent. Use of vasopressors and inotropes. Advanced heart failure (AHF) is a serious cause of mortality and morbidity in the United States. <<4385C31A2CECB04BA283E193D03C2420>]/Prev 124185/XRefStm 1449>> The PoppyPocket is a comfortable elastic chest band that completely encloses your medical pump and tubes. 0000006487 00000 n The haemodynamic effects of a continuous infusion of milrinone without an initial bolus dose were evaluated in patients undergoing off-pump coronary artery bypass graft surgery. Milrinone is used in patients with acute decompensated heart failure with reduced ejection fraction, as well as before and after cardiac surgery. I personally feel that all infusions should be administered via pump through picc lines. Generally, these are very ill patients waiting for heart transplants or to prolong life. and transmitted securely. 576 0 obj <>stream 4. These smart IV pumps are able to deliver medications and fluids to patients at a set rate programmed by nurses/clinical staff. Continuous Infusion: Dilution: Milrinone drawn from vials must be diluted. Intravenous [IV] milrinone, a phosphodiesterase III inhibitor, is the preferred drug for decompensated HF at most institutions. dobutamine, milrinone and/or dopamine for beneficiaries with American College of Cardiology Foundation/ American Heart Association Stage D heart failure (HF) or New York Heart Association Class IV HF if all of the following are met (for services provided prior to . Hypothetically, for an 80 kg patient, the infusion rate to deliver a dose of 0.25 mcg/kg/minute would be 6 mL per hour, using a 20 mg/100 mL milrinone infusion bag. When it is infused at home, Milrinone, which is an intravenous inodilator agent, reduces the number of hospitalizations. Dobutamine and milrinone are IV medications given through an infusion pump into your vein. 0000008180 00000 n However, in limited circumstances, inotropic drugs are sometime gives in intermittent doses two or three times a week. Physician Prescribing Information. 0000005821 00000 n sharing sensitive information, make sure youre on a federal Common side effects of milrinone may include: headache; chest pain; or dizziness. 0000007320 00000 n Plymouth Meeting, PA 19462. Despite limited data supporting long-term milrinone therapy in adults with congestive heart failure, Article Text. 0000012203 00000 n Unable to load your collection due to an error, Unable to load your delegates due to an error. Milrinone may be hypotensive because of its vasodilatory activity. Milrinone increases contractility and reduces afterload . Many patients with end-stage heart failure die from cardiac pump failure, and the impact . Concentration: 1 mg/mL. Sterile, Single Dose Vials: Single dose vials of 10, 20 and 50 mL contain in each mL milrinone lactate equivalent to 1 mg milrinone and 47 mg Dextrose Anhydrous, USP, in Water for Injection, USP. The CADD -Solis Infusion System offers a modern portable design with wireless connectivity and versatility for pain management.Supported therapies include: IV PCA. The common inotropic medications used include Milrinone (Primacore), Dopamine and Dobutamine. 5@(00@ va?W*83n``W K00>S@uiU@YV.'u$K : Our Home Infusion Therapy division brings to life the idea of "IV anywhere". The effect of milrinone infusion on right ventricular function during coronary anastomosis and early outcomes in patients undergoing off-pump coronary artery bypass surgery Article Full-text available Prior to this incident, the resident was not aware of this function. hUmO0+4_"!iD`FI}'JKmh`F5M The per mL concentration, 200 mcg (0.2 mg)/mL, is the most prominent expression of the drug concentration, listed in large text right below the drug name at the center of a blue background on the label (Figure 1). %PDF-1.4 % Data will be collected over the 6 hour infusion. 0000021532 00000 n 0000005329 00000 n To install infusion administration set (tubing) into backup pump, refer to the Patient Information Guide. hb``` cB @RFk9^2gRVV-WXhY"@AAIAPQAHQL1yJ The resident was unfamiliar with the smart infusion pump available for use in theoperating room (OR). 0000013119 00000 n Weaning: The infusion should be weaned slowly (2-4-hourly), monitoring for clinical signs of inadequate cardiac output. The two most common drugs associated with this therapy, Milrinone and Dobutamine, are usually given continuously over a 24 hour period with an ambulatory infusion pump such as the Curlin 6000 or CADD Prizm. Milrinone is typically seen in the ICU as an infusion, with a set rate of administration. 0000007628 00000 n Safe Practice Recommendations: Leadership must establish that the use of smart infusion pumps with an engaged drug library is an expected practice in the OR for all continuous medication infusions, intermittent and secondary infusions, loading and bolus doses, patient-controlled analgesia infusions, epidural and nerve block infusions, and infusions of hydrating solution (except when the hydrating fluid administration rate is greater than the pump allows).
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