Banana bags

[flightdoc09]

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ED Doc here. I was wondering what y'all's thoughts are on banana bags. Also, is there are standardized table of what goes in them? My understanding is thiamine, folate, multivitamin, +/- some magnesium and +/- some potassium. And they're supposed to be run over 8 hours, but can be sped up to 4 hours?

Trying to get a better idea of how to treat alcoholics that don't meet inpatient criteria, but could definitely use a tune up with some nutrition. I know a lot of docs just give PO vitamins because they're quick and significantly cheaper. But I remember a pharmacist in residency telling me that if I'm actually concerned for severe deficiency and patient is at risk for ecephalopathy, then they'll need IV.

Are there some things you'd recommend IV, some PO? Or instead of the banana bag, just splitting it up and doing individually? I know I just spilled a lot of words out, but I hope my questions and what I'm trying to learn make sense.

 

[mustang sally]

There is no standard banana bag unless it has been defined by your institution.

We do have some outpatients where we run the bags over two hours, but I consider this as the bare minimum and usually do 4 hours if they are inpatient.

I don't have a strong opinion on IV vs PO in this scenario. Sometimes it's just easiest to do the banana bag (assuming you have pharmacy available to mix in a sterile environment). Our pharmacy is closed overnight, so banana bags aren't done on the overnights...in that instance, we do recommend that the order be broken down into individual components.