We have been having some discussion regarding calcium chloride IV push and if there should be restrictions as to who can order it and where it can be administered. Calcium chloride 100mg/mL syringes are loaded in our Pyxis machines, are available via override in emergency situations and are stocked in our code carts. I would love to hear if other hospitals have any restrictions on calcium chloride IV push and what they are. Thanks!

Hi! I am wondering if anyone has a reference/resource to share for dating of famotidine inj. (and which NDC/manufacturer) stored at room temperature. We have been using 90 days but when we dug into the references, it was for a manufacturer that no longer makes famotidine and current manufacturer states no excursion data for storage at room temperature. Thank you!

HI All

We recently added an entry into our smart pumps (Baxter sigma) for a lipid infusion to treat LAST (LA toxicity). We realized that if the patient weighs over 66 kg, the suggested dosing of 0.25mL/kg/min (based on IBW) is too fast for the pump to deliver. Our pumps max at 999mL/h. If anyone could share how they do this in their institution, it would be very much appreciated.

As a pediatric hospital that has recently transitioned to Epic, we are encountering challenges with the application of multiple labels (three or four) on our smaller oral syringes (0.5 mL and 1 mL). Our nursing staff is reporting that these labels do not adhere well and frequently detach from the syringes. I am interested in learning how other institutions are addressing this issue. What strategies or best practices have you found effective for labeling small-volume oral syringes?

Thank you!

Nick

With the recall of the 2025 AirLife Broselow tape our team is looking for alternative options.

For institutions who use Broselow tape, how are you modifying your practice given the recall?

For those who are not using Broselow tape, what other resources do you use for pediatric emergencies? 

Hello,

am seeking examples of policies or procedures related to follow-up actions for staff involved in a medication error.

While we recognize the importance of maintaining a non-punitive, process-focused approach, I am interested in learning whether others have implemented any structured processes that address individual accountability when appropriate.

Specifically, I am curious about practices such as staff education, use of tracers, or other follow-up mechanisms. Any policies, tools, or experiences you are willing to share would be greatly appreciated.

Succinylcholine vials made by Hikma (NDC: 0143-9338-25) have a YELLOW cap, which is a departure from the unofficial standard practice of using red caps for succinylcholine.

These yellow-capped succinylcholine vials with orange labeling are strikingly similar to ephedrine vials, as shown in the attached photo.

We utilize the ICU Medical Rio devices and have recently been getting multiple lot numbers that have contaminated spikes, etc. Most contain a black substance on them but we have seen one with what appears to be a fabric thread. We have engaged ICU Medical and have submitted to the FDA and ISMP. Are others seeing this?

I've seen this topic posted on here a few times, but I'm specifically wondering about Canadian sites/health authorities. Do any Canadian sites provide EpiPens for the initial treatment of anaphylaxis in acute care?

For anyone who has considered this, can you share why you did or didn't choose to provide EpiPens (besides cost)?

Dear Colleagues,
We have recently implemented automated carousel systems in our inpatient pharmacy.
Based on our review of NIOSH, USP <800, cytotoxic (hazardous) medications require segregated storage, and we could not find any explicit guidance permitting their storage with non-hazardous medications or within the same automated carousel system.
I would appreciate your input on the following:
•Do any international guidelines, standards, or regulatory bodies explicitly allow or address storage of oral cytotoxic medications within automated carousel systems?