KCL 40 mEq/100 mL IVPB is also critically short. This afternoon, iCare changes will go into effect that prompt the nurse to remove 2 of the KCl 20 mEq/100 mL IVPBs for a 40 mEq dose! Of course this will provide twice the fluid volume of the KCl 40 mEq/100 mL piggyback. For that reason, there will be an option for patients who are severely fluid restricted to receive a 40 mEq/100 mL piggyback. Access to enter the order for the 40 mEq/100 mL piggyback will be located under "Electrolytes" in the "NSS Meds" section of the NSS/PKS button in iCare (see screenshot below). A label will print for dispensing (will print in PSP at Main) if the 40 mEq/100 mL commercial product is not loaded in that Pyxis machine.

From: Becky Ginn
To: Pharmacy Department
Sent: Tuesday, March 20, 2018 8:50:22 AM
Subject: KCl 20 mEq piggybacks - IVPB volume change LA/SA!!

Due to the shortage of BOTH small volume IV fluids (piggybacks) and potassium chloride vials, beginning this afternoon KCl 20 mEq IVPB doses ENTERED INTO iCARE will use the commercially available 20 mEq/100 mL piggybacks (999554). Previously this dose/concentration was 20 mEq/50 mL (17611). This will affect all three hospitals later today.

Please refer to the attached picture (also below) for the LOOK ALIKE/SOUND ALIKE for these two piggybacks. Use extreme caution as both volumes will potentially be available/dispensed. This new concentration (20 mEq/100 mL) IS AVAILABLE FOR NURSES TO PICK WITH THE MOST RECENT IV PUMP UPDATES.

It is likely that the remaining stock of the 20 mEq/50 mL piggybacks will be used up in NON-profile Pyxis machines. So both products will be in the distribution pipeline.

 
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Becky Ginn, Pharm.D.
Huntsville Hospital