FAQ

Frequently (and not so frequently) Asked Questions

 

CADD (PCA) PUMP RELATED

What do I do when there is High Pressure indicated on the CADD Pump screen?

The CADD pump indicated high pressure generally due to one of two things. First make sure the clamp on the tubing near the entrance to the cassette is not clamping down. If that is okay, the more likely possibility is a kink in the tubing. Follow the tubing from the cassette down to the patient’s IV site. A lot of time the tubing is kinked or the patient is resting on the tubing. Once the problem is solved, it may take a few seconds for the pressure to stabilize and for the pump to stop showing High Pressure.

 

What do I do with a CADD (PCA) pump when we no longer need it?

Call the Hospicare pharmacy and let us know when we can come and pick it up from the residence or facility!

 

How often should I change a subcutaneous set?

Although the literature suggests 1 to 14 days depending on the medication and infusion site, subcutaneous sets should be changed every 72 hours.

 

How do I change the rate, dose, etc. on the CADD Pump?

Call Hospicare Pharmacy 24/7 and we’ll help you (the nurse) over the phone!

 

How do I prime the pump?

Call Hospicare Pharmacy 24/7 and we’ll help you (the nurse) over the phone!

 

PAIN CONTROL

Can Oxycontin be administered rectally?

Yes. According to the manufacturer, it is not indicated for rectal administration as it leads to a 39% greater AUC and 9% greater Cmax leading to greater adverse effects. However, a few studies on rectal administration have been conducted in cancer patients resulting in satisfactory pain control with slight increases in adverse effects.1-3

 

Can Valium be administered sublingually?

Yes

 

 

 

FEEDING/ENTERAL

 

How long can Infuvite stay outside of  the fridge before reconstituting it?

According to the manufacturer (Sandoz Canada), Infuvite can stay outside of the refrigerator for up to 14 days before reconstituting. Once replaced in the fridge (before 14 days) it is once again good until the expiration date on the vial.

 

How long is Infuvite good for once it is reconstituted and injected into the IV bag?

Once reconstituted, Infuvite is stable for up to 24 hours and any remaining must be discarded thereafter.

 

Can the Kangaroo pump administer feeding continuously AND a bolus of water (or whatever) from another bag every X hours?

Yes! It requires a Kangaroo Epump Set with flush bag (we carry it!). It is essentially two bags that connect at a Y-site to form a single tube that feed into the machine. You have to turn off the machine, feed the new line, then turn it on again. The pump will know the type of setup (one bag versus two via a magnet in the tubing) and allow you to program a continuous or intermittent flow of the feeding bag as well as a bolus amount and time interval for the second bag.

References:

  • 1. Clinical observations on safety and efficacy of OxyContin® administered by rectal route in treating cancer related pain. Asian Pac J Cancer Prev. 2011;12(10):2477-8.
  • 2. Oxycontin Package Insert page 6
  • 3. http://en.cnki.com.cn/Article_en/CJFDTOTAL-XIBU201110031.htm

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