Approved Hospital Formulary
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Approved Hospital Formulary
10/01/18 DC -- sodium bicarb IV shortage
From: David Collette
Sent: Monday, October 1, 2018 1:23:39 PM
Subject: sodium bicarb IV shortage
We are once again facing a national backorder of injectable sodium bicarbonate. Keith is unable to obtain any of this product (syringes or vials) and we will need to strictly enforce our usage criteria as approved by P&T/MEC in late 2017. As a reminder, that criteria is:
* Documented metabolic acidosis in a critically ill patients, including bicarbonate drips in ICUs
* CV surgery
* High-dose methotrexate therapy
* Drug overdoses where alkalinization of the urine may be beneficial, including an overdose with a tricyclic antidepressant or aspirin
* Sodium bicarbonate injection is NOT approved for routine usage in Code-0 situations and will not be stocked in crash carts nor pharmacist code kits
Pharmacists in high-use areas (ICUs, ED, etc.), please notify your physicians of this situation . You are welcome to provide them with the usage criteria, including the letter that was sent to the entire medical staff in November of 2017 and which is available on FormWeb.
Please do not verify orders for sodium bicarb that do not STRICTLY meet this criteria. As before, we will be reserving the lion's share of IV bicarb for CV surgery. If necessary, we may be removing the bicarb that is loaded in Pyxis machines and bring it all to Pharmacy for better surveillance. I will keep you posted as this situation evolves (or devolves!).
DAVID
--
David R. Collette, Pharm.D., FASHP
Operations Manager, Professional Services
Sent: Monday, October 1, 2018 1:23:39 PM
Subject: sodium bicarb IV shortage
We are once again facing a national backorder of injectable sodium bicarbonate. Keith is unable to obtain any of this product (syringes or vials) and we will need to strictly enforce our usage criteria as approved by P&T/MEC in late 2017. As a reminder, that criteria is:
* Documented metabolic acidosis in a critically ill patients, including bicarbonate drips in ICUs
* CV surgery
* High-dose methotrexate therapy
* Drug overdoses where alkalinization of the urine may be beneficial, including an overdose with a tricyclic antidepressant or aspirin
* Sodium bicarbonate injection is NOT approved for routine usage in Code-0 situations and will not be stocked in crash carts nor pharmacist code kits
Pharmacists in high-use areas (ICUs, ED, etc.), please notify your physicians of this situation . You are welcome to provide them with the usage criteria, including the letter that was sent to the entire medical staff in November of 2017 and which is available on FormWeb.
Please do not verify orders for sodium bicarb that do not STRICTLY meet this criteria. As before, we will be reserving the lion's share of IV bicarb for CV surgery. If necessary, we may be removing the bicarb that is loaded in Pyxis machines and bring it all to Pharmacy for better surveillance. I will keep you posted as this situation evolves (or devolves!).
DAVID
--
David R. Collette, Pharm.D., FASHP
Operations Manager, Professional Services