sodium bicarb IV bags - any better solutions

[rxconquistador]

I work in a hospital pharmacy.

We make tons of IV bags with 8.4% sodium bicarb. However, we have to draw it out of a 50ml single dose.

I was told that they looked into it a while ago and mfg didn't sell larger bottles.

Does anyone work in a hospital pharmacy that makes IVs that has a better solution?

Thanks.

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[movie098]

You can look into having a compounding pharmacy compound bicarb bags for you in bulk. At the hospital I work at we do this for oxytocin bags, diluadid, etc. However, for us it wouldn't work for bicarb because how they are ordered varies greatly, but the case might be different where you work.

 

[BavarianMWE46]

I've been an IV compounder for about two years. There is too much variation in the fluids, some need NS, some 1/2NS, some 50 meq, 100 meq, 150 meq. There is just too much variation to stock all of those, for us atleast.

Just use a 60cc syringe, flip it, press the plunger on the hood, and let the positive pressure do the work for you. It takes like 20 seconds max.

 

[fugm]

I work at an admixture pharmacy, and our supplier has 50 and 500ml vials of sodium bicarb...

 

[rxconquistador]

250 ml or 500 ml would be perfect size. If you have a chance could you post which drug company makes it. Thanks!

We use 250 ml sodium chloride 23.4% and can just hang that upside down in the hood with a syringe attached and easily draw out doses to put in the IV bags throughout the day. Switching out the 250 bottles with the apparatus is easy. And time saver espeically for the CVVH.

I would love, love, love to do the same with sodium bicarb.

Thanks for the responses.

 

[thephoenician88]

I've been an IV compounder for about two years. There is too much variation in the fluids, some need NS, some 1/2NS, some 50 meq, 100 meq, 150 meq. There is just too much variation to stock all of those, for us atleast.

Just use a 60cc syringe, flip it, press the plunger on the hood, and let the positive pressure do the work for you. It takes like 20 seconds max.

this sounds awesome......it's seriously what i want to do during rotations.

 

[fugm]

the brand we have is Cura Pharmaceuticals.

 

[krystal2812]

guys, can you tell me how can you get the job as a tech making IV? I really want to do but don't know how to start.

 

[pearljam5a1]

At my pharmacy we use the larger 500 mL bottles of Bicarb as well. I just spike it with a pediatric spike (what we call them at least) and hang it in the hood. Recently we had some trouble getting them in through some sort of Mfr. stock issue and it was awful. Drawing up 150 cc from 3 separate 50 mL vials is a pain and then you have to draw out 150 cc from the bag as well. We use large gauge needles whenever possible, purple packaging with a triangular blade on the end and it makes it much easier.

Like the previous poster said, draw back on the syringe before you enter the vial to make your life easier and save yourself some wrist problems.

 

[Joe9100]

In our pharmacy, we simply carry 50ml bicarbs. Most of the time we add the bicarb to a liter bag but we never -/+ the volume to keep the volume at a constant 1 liter. I didn't know that there is bicarbs available at a 500mL volume. Do you guys hang that at a machine and it draws it up for you automatically? Wee do have a Baxa machine that is dedicated for TPN and making bags and saline solutions for epidurals.

I don't believe the bicarbs are that big of a hassel. The things that I hate making the most are lido and bicarbs, orencia, remicade, and erythromycin IVPB.

 

[pearljam5a1]

In our pharmacy, we simply carry 50ml bicarbs. Most of the time we add the bicarb to a liter bag but we never -/+ the volume to keep the volume at a constant 1 liter. I didn't know that there is bicarbs available at a 500mL volume. Do you guys hang that at a machine and it draws it up for you automatically? Wee do have a Baxa machine that is dedicated for TPN and making bags and saline solutions for epidurals.

I don't believe the bicarbs are that big of a hassel. The things that I hate making the most are lido and bicarbs, orencia, remicade, and erythromycin IVPB.

We follow the 10% rule where I work, ie If you add over 100 mL to 1000 mL you have to draw out first.

I hate making anything that doesn't go into solution right away or that bubbles up. I really hate Imipenem with a passion too.

 

[Praziquantel86]

We follow the 10% rule where I work, ie If you add over 100 mL to 1000 mL you have to draw out first.

I hate making anything that doesn't go into solution right away or that bubbles up. I really hate Imipenem with a passion too.

Try AmBisome...worlds of fun.

 

[fugm]

guys, can you tell me how can you get the job as a tech making IV? I really want to do but don't know how to start.

Apply...at an admixture or compounding pharmacy, or even a hospital.

 

[WVUPharm2007]

lol....making IVs is cool for like the first week or so. Then it gets repetitive, boring, and annoying.

And, no, those 50cc vials of bicarb are the most economical and practical way to infuse the drugs...you're just going to have to live with it.

 

[Thumper17]

I hate Rifampin and Venofer, if I get one drop on the hood I have to spend the next 5 minutes scrubbing!

 

[rjk]

My place prepares a ton of Bicarb bags, only for them to sit and expire.

And I would much rather make bicarb than Dantrolene. Man, I hate that drug.

 

[aboveliquidice]

We prep each bag in the hood (500ml) - setup the repeater pump to draw out the overfill + the bicarb addition... Then draw up Bicarb (using positive pressure via 60 cc syringe) and make literally 40 or 50 bags in about 20 or 30 min (depends on whether or not you are in a hurry).

Esmolol sucks way more in my opinion... Several hundreds of those / night.

 

[BavarianMWE46]

I hate Rifampin and Venofer, if I get one drop on the hood I have to spend the next 5 minutes scrubbing!

Rifampin looks so cool, it so colorful and looks neat diffusing in the solution. I guess I'm kinda bored after staring at yellowish bags of NS all day.

I hate daptomycin the most. It takes forever to dissolve, if you shake it, it turns into foam, once you get it to dissolve and you inject it into the bag too fast, it turns into foam.

 

[BavarianMWE46]

lol....making IVs is cool for like the first week or so. Then it gets repetitive, boring, and annoying.

Werd, its cool until your director decides that compounding 3.375g Zosyn from a 40g stock vial is more economical than buying frozen premixes. I made 132 bags of 3.375g last night. It was the suck.

I also had to make 5 bags of Alum irrigation for a bloody prostate patient running around 3 liters every two hours. Microwave NS, dissolve the Alum, inject through 5 clogging .22 micron filters, sucked. Took about an hour and a half.