From: Becky Ginn
Sent: Wednesday, August 23, 2017 10:03 AM
To: Pharmacy Department
Subject: bupivacaine with EPINEPHrine KITS to be loaded due to backorder
Importance: High

Due to an ongoing shortage of bupivacaine 0.25% with EPINEPHrine 30 mL vials and bupivacaine 0.5% with EPINEPHrine 30 mL vials, we will begin loading "kits" (similar to the lidocaine with EPINEPHrine kits we are currently loading). This will start TODAY at Main and HHWC will follow shortly.

Each kit will contain a 30 mL vial of plain bupivacaine PLUS a PSP-prepared EPINEPHrine syringe to be injected, by the nurse, into the bupivacaine vial. This will result in a bupivacaine with EPINEPHrine product. Instructions for the nurse will be on the outside of the amber bag. PLEASE NOTE THE EPINEPHrine CONTAINS PRESERVATIVES! The backordered product was preservative free. There is a warning sticker on the amber bag indicating that the kit "Contains Preservatives". Pharmacy has communicated this to OR management who is aware the EPINEPHrine is not PF. Pyxis ES has also been updated to eliminate the PF designation.

We will need to continue with this process until the shortage is resolved. Currently the resolution is expected in mid to late September.

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Becky Ginn, Pharm.D.
Huntsville Hospital