Do you use sterile oral syringes to dispense compounded nebulization solutions rather than IV syringes for safety reasons?

Thinking about racemic epinephrine shortage .

We are reviewing the ISMP Quarterly Alert Agenda and downtime workflows are being discussed. We recently had a significant unplanned EHR and phone downtime and prescription pads were needed.
1. Do you keep prescrption pads on all nursing units? or just ED and pharmacy?
2. If yes, Who controls the security of those pads?
3. If no, do you keep them in the ADC instead?
4. How do you handle need for CII Rx during downtime?

Any info would be helpful! Thanks.

Happy Wednesday!

Does anyone use or had a request to use MKO Melts? One of our orthopedic surgeons wants more information on the product- I have yet to inquire with him about his potential intent and he may just want more information. What I do (think I) know is that this would still constitute "procedural sedation" or "moderate sedation" despite the fact that it is oral. It appears that I would be able to order like any other 503B process or even 503A if I prefer. I wanted to reach out to find out more about how facilities may be using this product.

Thanks!

Hi everyone,

Would someone be willing to share their pediatric DKA protocol? We are mainly an adult-centered hospital as we do not have a PICU; we do have a small pediatric unit.

Thank you in advance,
Shirley Guan

We have had a chronic, low level issue of pump programming errors for norepinephrine infusions in which the RN misses a zero in the dose field when titrating norepinephrine resulting in 10-fold overdoses (e.g. 0.8 mcg/kg/min programmed instead of the intended 0.08 mcg/kg/min). We occasionally have reports of under-doses as well when an extra zero is added to the dose by mistake.

Hi all! Pharmacy currently compounds tumescent solution for our OR cases but the MDs are requesting that these be warmed to body temperature. Wondering if anyone has encountered this request and what BUD is being assigned.

Hi everyone. Was wondering if anyone can share their policy related to REMS management?

We are looking to create a pharmacy report card that reviews all of the override information on a monthly basis.

Hello Everyone,
We are looking to standardize our process for epinephrine for the use in anaphylaxis.
Would love to see if other hospitals have a virtual epinephrine anaphylaxis kit, physical kit or epi pens.
Please share as to your process/practice and what you have in your hospital. Please share what your kit contains if possible.

Thank you,
Viktoriya Fridman, Pharm.D.
Medication Safety Officer
Ocean University Medical Center
Brick, New Jersey

Hi,