Multi-use omnipaque vials?

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tmvguy03

tmvguy03

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Hey all- are there any version of omnipaque (or similar) that is specifically labeled as “multi-use” and not a “single use” vial? Would be great to not waste so much contrast….
 
if you are HOPD, talk to the hospital pharmacy about separating the single use vials in to separate syringes.
 
do you mean you are using SDV as MDV?

thats okay... until you have an outbreak.

so dont have an outbreak...
 
I use multiuse Isovue-200 exclusively.
 
Hard times calls for using SDV as MDV. Any thoughts on if refrigeration overnight mitigates (or increases) any risks?
 
pmrmd said:
With a new needle every time? Doesn’t happen.
Click to expand...
scary...


CDC:

ACR:
www.ashp.org

Considerations for Imaging Contrast Shortage Management and Conservation - ASHP

This fact sheet summarizes the status of the current shortage of iohexol and provides considerations for shortage management strategies
www.ashp.org

www.acr.org

Statement from the ACR Committee on Drugs and Contrast Media

www.acr.org www.acr.org

it is not recommended to reuse SDV.
 
Ducttape said:
scary...


CDC:

ACR:
www.ashp.org

Considerations for Imaging Contrast Shortage Management and Conservation - ASHP

This fact sheet summarizes the status of the current shortage of iohexol and provides considerations for shortage management strategies
www.ashp.org

www.acr.org

Statement from the ACR Committee on Drugs and Contrast Media

www.acr.org www.acr.org

it is not recommended to reuse SDV.
Click to expand...
CDC is propaganda fluff. Not science
ACR has science. And fine to repackage by pharmacy for 30hrs room temp and 9 days in frig.

We also have tens of thousands of patients who have had SDV contrast administration using single needle, single syringe, no re-entry with used needle or syringe, and alcohol swabbed top. It isn’t reported due to liability risk. Most docs will discard bottle at end of day if any contrast remains. I know of several practices that have done this over 20+ years. No outbreaks in Georgia.
 
Granted, I no longer do that. But I support those who do.

Wrong:

Running out of contrast in procedure and using same needle or same syringe to go back in to a bottle (MDV or SDV.

Not swabbing any bottle before entry. New or previously opened.

Drawing the entire days medication out of a bottle and storing in syringes for rest of day.
 
Ducttape said:
scary...


CDC:

ACR:
www.ashp.org

Considerations for Imaging Contrast Shortage Management and Conservation - ASHP

This fact sheet summarizes the status of the current shortage of iohexol and provides considerations for shortage management strategies
www.ashp.org

www.acr.org

Statement from the ACR Committee on Drugs and Contrast Media

www.acr.org www.acr.org

it is not recommended to reuse SDV.
Click to expand...
Is any of this evidence of an outbreak?

It’s contrast. Show me what grows in it.
 
Many thousands of procedures with not one infection in our group.

Safe and cost-effective.

To argue the other direction is like saying, "Learn to code" or "Buy a Tesla."
 
your comment lends itself to misinterpretation - a hospital pharmacy can set up small syringes of contrast but it has to be under a sterile hood.

mine has been doing that for me since May, when i asked the inpatient pharmacy to look in to this issue. we get 3 doses out of 1 10 ml vial.




fyi, we have tens of thousands of people who get TFESI with particulate without paralysis. yet you use dex for TFESI.

we have had tens of thousands of people get epidurals (including labor) without fluoro, yet you would never do an epidural without fluoro.

we have had US based facet injections, which currently do not pass CMS muster. yet you did not recommend we do them.



just because one has not been sued for harm doesnt mean it does not exist.

it also doesnt make it right.

MitchLevi said:
We have reused SDV for yrs, and to say we're dangerous is asinine and absurd.

Availability + risk profile = No reason to change.
Click to expand...

ASRA doesnt agree with the standard practice of reusing SDV, or even with the current shortages.



SIS previously said not a good practice






same with American College of Radiology, as noted above. other organizations like Pharmacy ones, or Joint Commission...


go ahead, keep doing your current injection practice. but dont think that you are doing things the safe way, because you are not. if you get an outbreak, good luck..
 
Ducttape said:
your comment lends itself to misinterpretation - a hospital pharmacy can set up small syringes of contrast but it has to be under a sterile hood.

mine has been doing that for me since May, when i asked the inpatient pharmacy to look in to this issue. we get 3 doses out of 1 10 ml vial.




fyi, we have tens of thousands of people who get TFESI with particulate without paralysis. yet you use dex for TFESI.

we have had tens of thousands of people get epidurals (including labor) without fluoro, yet you would never do an epidural without fluoro.

we have had US based facet injections, which currently do not pass CMS muster. yet you did not recommend we do them.



just because one has not been sued for harm doesnt mean it does not exist.

it also doesnt make it right.



ASRA doesnt agree with the standard practice of reusing SDV, or even with the current shortages.



SIS previously said not a good practice






same with American College of Radiology, as noted above. other organizations like Pharmacy ones, or Joint Commission...


go ahead, keep doing your current injection practice. but dont think that you are doing things the safe way, because you are not. if you get an outbreak, good luck..
Click to expand...
Nope.
 
There is no contrast available unless you are owned by a hospital.

Therefore tens to hundreds of thousands of Americans are going to have no epidurals and sympathetic blocks available to them very soon. The hospitals cannot absorb all of them; the hospitals are barely functional.

The public health cost is going to be massive.

These organizations need to wake up to the reality we are in a serious medication crisis and STOP contributing to this crisis by causing well intentioned physicians to waste a 48mL of a 50mL bottle per patient. This is absurdly wasteful in time of crisis.

Note, the shortage is NOT letting up. It was expected to let up in June. Not even the slightest uptick in availability.
 
And hospitals keep buying in hordes all the contrast . See lobel's pics? Meanwhile solo practices like ligament and me can't get any? Is that fair?
 
You can get large volume single dose vials and use them as multi dose…they are available not just to hospitals. You just gotta have cajones to use them.

I don’t even view it as dramatically as that btw..just trying to pony onto this thread
 
Ligament said:
There is no contrast available unless you are owned by a hospital.

Therefore tens to hundreds of thousands of Americans are going to have no epidurals and sympathetic blocks available to them very soon. The hospitals cannot absorb all of them; the hospitals are barely functional.

The public health cost is going to be massive.

These organizations need to wake up to the reality we are in a serious medication crisis and STOP contributing to this crisis by causing well intentioned physicians to waste a 48mL of a 50mL bottle per patient. This is absurdly wasteful in time of crisis.

Note, the shortage is NOT letting up. It was expected to let up in June. Not even the slightest uptick in availability.
Click to expand...
Don’t waste it brah
 
I am owned by a hospital, but my contrast is coming from a supplier in Orlando and not from the hospital. My hospital has a shortage as well.
I am unsure who is doing our office based purchasing except for Lisa (in my office, downstairs)
 
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