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Approved Formulary

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IHS FormWeb

Approved Formulary

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IHS Special Fluid Compounding
Considerations for the preparation of special fluids • Ignore overfill in fluid bag • Start with a fluid bag different than sterile water for injection • To prepare base bag first: Remove from bag same volume of D₅₀W and/or NaCl 4 mEq/mL that will be added to obtain desired concentration • If additional additives are ordered (i.e., heparin, KCl, or Calcium gluconate), remove from prepared base bag the same volume of additives that will be added to obtain the ordered preparation • Due to the multiple additives options, BUD is limited to 24 hrs room temperature or refrigerated
Additive Options for Specified Bags
Volume	Heparin 100 unit/mL Dilution (0.5 unit/mL)	KCl 2 mEq/mL vial (20 mEq/L)	Calcium Gluconate 100 mg/mL vial (for 2.68 g/L)	Calcium Gluconate 100 mg/mL vial (for 5.2 g/L)
250 mL	1.25 mL	2.5 mL	6.7 mL	13 mL
500 mL	2.5 mL	5 mL	13.4 mL	26 mL
1000 mL	5 mL	10 mL	26.8 mL	52 mL
Click on desired fluid row to expand the detail
Desired fluid: D₅ & 0.2% NaCl ^1,4,5,6,7 Total Volume D₅W Bag ³ NaCl 4 mEq/mL Vial 250 mL 247.6 mL 2.4 mL 500 mL 495.2 mL 4.8 mL 1,000 mL 990.4 mL 9.6 mL ¹ Use commercial 250 mL bag when available (Bbraun NDC 0264-7623-20) ³ Use commercial bag option ⁴ Heparin may be added to obtain 0.5 unit/mL per bag ⁵ Potassium Chloride may be added to bag to obtain 20 mEq/L of fluid ⁶ Calcium Gluconate may be added to obtain 2.68 g/L of fluid ⁷ Calcium Gluconate may be added to obtain 5.2 g/L of fluid
Desired fluid: D₅ & 0.45% NaCl ^2,4,5,6,7 Total Volume D₅W Bag NaCl 4 mEq/mL Vial 250 mL 245.2 mL 4.8 mL 500 mL 490.4 mL 9.6 mL 1,000 mL 980.7 mL 19.3 mL ² Use commercial 1000 mL bag when available (Bbraun NDC0264-7622-00) ⁴ Heparin may be added to obtain 0.5 unit/mL per bag ⁵ Potassium Chloride may be added to bag to obtain 20 mEq/L of fluid ⁶ Calcium Gluconate may be added to obtain 2.68 g/L of fluid ⁷ Calcium Gluconate may be added to obtain 5.2 g/L of fluid
Desired fluid: D₅ & 0.9% NaCl ^4,5 Total Volume D₅W Bag ³ NaCl 4 mEq/mL Vial 250 mL 240.4 mL 9.6 mL 500 mL 480.7 mL 19.3 mL 1,000 mL 961.5 mL 38.5 mL ³ Use commercial bag option ⁴ Heparin may be added to obtain 0.5 unit/mL per bag ⁵ Potassium Chloride may be added to bag to obtain 20 mEq/L of fluid
Desired fluid: D_7.5W ⁴ Total Volume D₅W Bag ³ D₅₀ Vial 250 mL 236.1 mL 13.9 mL 500 mL 472.2 mL 27.8 mL 1,000 mL 944.4 mL 55.6 mL ³ Use commercial bag option ⁴ Heparin may be added to obtain 0.5 unit/mL per bag
Desired fluid: D₁₀ & 0.2% NaCl ^1,4,5,6,7 Total Volume D₁₀W Bag ³ NaCl 4 mEq/mL Vial 250 mL 247.6 mL 2.4 mL 500 mL 495.2 mL 4.8 mL 1,000 mL 990.4 mL 9.6 mL ¹ Use commercial 250 mL bag when available (Bbraun NDC 0264-7623-20) ³ Use commercial bag option ⁴ Heparin may be added to obtain 0.5 unit/mL per bag ⁵ Potassium Chloride may be added to bag to obtain 20 mEq/L of fluid ⁶ Calcium Gluconate may be added to obtain 2.68 g/L of fluid ⁷ Calcium Gluconate may be added to obtain 5.2 g/L of fluid
Desired fluid: D₁₀ & 0.45% NaCl ^2,4,5,6,7 Total Volume D₁₀W Bag NaCl 4 mEq/mL Vial 250 mL 245.2 mL 4.8 mL 500 mL 490.4 mL 9.6 mL 1,000 mL 980.7 mL 19.3 mL ² Use commercial 1000 mL bag when available (Bbraun NDC0264-7622-00) ⁴ Heparin may be added to obtain 0.5 unit/mL per bag ⁵ Potassium Chloride may be added to bag to obtain 20 mEq/L of fluid ⁶ Calcium Gluconate may be added to obtain 2.68 g/L of fluid ⁷ Calcium Gluconate may be added to obtain 5.2 g/L of fluid
Desired fluid: D₁₀ & 0.9% NaCl ^4,5 Total Volume D₁₀W Bag ³ NaCl 4 mEq/mL Vial 250 mL 240.4 mL 9.6 mL 500 mL 480.7 mL 19.3 mL 1,000 mL 961.5 mL 38.5 mL ³ Use commercial bag option ⁴ Heparin may be added to obtain 0.5 unit/mL per bag ⁵ Potassium Chloride may be added to bag to obtain 20 mEq/L of fluid
Desired fluid: D_12.5W ⁴ Total Volume D₁₀W Bag ³ D₅₀ Vial 250 mL 234.4 mL 15.6 mL 500 mL 468.7 mL 31.3 mL 1,000 mL 937.5 mL 62.5 mL ³ Use commercial bag option ⁴ Heparin may be added to obtain 0.5 unit/mL per bag
Desired fluid: D_12.5 & 0.2% NaCl ⁸ Total Volume D₁₀W Bag ³ D₅₀ Vial NaCl 4 mEq/mLVial 250 mL 232 mL 15.6 mL 2.4 mL Vial 500 mL 463.9 mL 31.3 mL 4.8 mL Vial 1,000 mL 927.9 mL 62.5 mL 9.6 mL Vial ³ Use commercial bag option ⁸ Non standard concentration (not included in order set)
Desired fluid: D_12.5 & 0.45% NaCl ^4,5 Total Volume D₁₀W Bag ³ D₅₀ Vial NaCl 4 mEq/mLVial 250 mL 229.6 mL 15.6 mL 4.8 mL Vial 500 mL 459.1 mL 31.3 mL 9.6 mL Vial 1,000 mL 918.2 mL 62.5 mL 19.3 mL Vial ³ Use commercial bag option ⁴ Heparin may be added to obtain 0.5 unit/mL per bag ⁵ Potassium Chloride may be added to bag to obtain 20 mEq/L of fluid
Desired fluid: D_12.5 & 0.9% NaCl ^4,5 Total Volume D₁₀W Bag ³ D₅₀ Vial NaCl 4 mEq/mLVial 250 mL 224.8 mL 15.6 mL 9.6 mL Vial 500 mL 449.4 mL 31.3 mL 19.3 mL Vial 1,000 mL 899 mL 62.5 mL 38.5 mL Vial ³ Use commercial bag option ⁴ Heparin may be added to obtain 0.5 unit/mL per bag ⁵ Potassium Chloride may be added to bag to obtain 20 mEq/L of fluid
Desired fluid: D₁₅W ^4,5 Total Volume D₁₀W Bag ³ D₅₀ Vial 250 mL 218.7 mL 31.3 mL 500 mL 437.5 mL 62.5 mL 1,000 mL 875 mL 125 mL ³ Use commercial bag option ⁴ Heparin may be added to obtain 0.5 unit/mL per bag ⁵ Potassium Chloride may be added to bag to obtain 20 mEq/L of fluid
Desired fluid: D₁₅ & 0.45% NaCl ^4,5 Total Volume D₁₀W Bag ³ D₅₀ Vial NaCl 4 mEq/mLVial 250 mL 213.9 mL 31.3 mL 4.8 mL Vial 500 mL 427.9 mL 62.5 mL 9.6 mL Vial 1,000 mL 855.7 mL 125 mL 19.3 mL Vial ³ Use commercial bag option ⁴ Heparin may be added to obtain 0.5 unit/mL per bag ⁵ Potassium Chloride may be added to bag to obtain 20 mEq/L of fluid
Desired fluid: D₁₅ & 0.9% NaCl ^4,5 Total Volume D₁₀W Bag ³ D₅₀ Vial NaCl 4 mEq/mLVial 250 mL 209.1 mL 31.3 mL 9.6 mL Vial 500 mL 418.3 mL 62.5 mL 19.2 mL Vial 1,000 mL 836.5 mL 125 mL 38.5 mL Vial ³ Use commercial bag option ⁴ Heparin may be added to obtain 0.5 unit/mL per bag ⁵ Potassium Chloride may be added to bag to obtain 20 mEq/L of fluid
Desired fluid: D₂₀W ⁸ Total Volume D₁₀W Bag ³ D₅₀ Vial 250 mL 187.5 mL 62.5 mL 500 mL 375 mL 125 mL 1,000 mL 750 mL 250 mL ³ Use commercial bag option ⁸ Non standard concentration (not included in order set)
Desired fluid: D_22.5W ⁸ Total Volume D₁₀W Bag ³ D₅₀ Vial 250 mL 171.9 mL 78.1 mL 500 mL 343.7 mL 156.3 mL 1,000 mL 687.5 mL 312.5 mL ³ Use commercial bag option ⁸ Non standard concentration (not included in order set)
Desired fluid: D₂₅W ⁸ Total Volume D₁₀W Bag ³ D₅₀ Vial 250 mL 156.3 mL 93.7 mL 500 mL 312.5 mL 187.5 mL 1,000 mL 625 mL 375 mL ³ Use commercial bag option ⁸ Non standard concentration (not included in order set)

Pharmacy Contact Info:

Main Inpatient Pharmacy: ext 4599, 3503
Fax: 704-878-7283

Director of Pharmacy - Randi Raynor, PharmD: ext 4501
Clinical Coordinator - Laura Rollings, PharmD: ext 4597
Pharmacy Informaticist - Stephen Pringle, PharmD: ext 7645
Pharmacy Technician Supervisor - Amy Wingler, CPhT: ext 7385
Pharmacy Automation Coordinator (Omnicell) - Melissa Fulford, CPhT: ext 3556

This site is intended for the staff of Iredell Health System. While others may view accessible pages, Iredell Health System makes no warranty, express or implied, as to the use of this information outside of Iredell Health System. The content of this policy and procedure document serves as guidance to the delivery of quality patient care. Care providers are expected to exercise critical thinking and situational awareness skills, and in specific situations to take such action as is necessary for the delivery of quality patient care.