**ALWAYS establish patent IV access and flush PRIOR to mixing medication**
Pharmacy specific orders / instructions always supersede the Agency guidance provided below. If in doubt, do not guess, call our office, or tag @TeamHelp-CareCoordination(Best Tag) and ask for Clinical Support.
ALWAYS establish IV access prior to mixing any meds
ALWAYS make sure you have everything you need to complete infusion before you begin
ALWAYS confirm your medication dose against the medication label and orders
ALWAYS reach out to us first (not the Pharmacy) with any questions
NEVER tell a Pt you have not given a particular medication before
MIXING
Obtain a clear/clean space to prepare your bag of Actemra.
Pharmacy provides needles and 60mL syringes to prepare medication.
Be sure all the necessary supplies are available to complete infusion from beginning to end.Â
You will need IV start supplies, syringe(s), needle, bag of NS, tubing (gravity tubing or pump tubing if using a pump).
Determine the volume of Actemra to be infused. Remove and discard that volume of saline from the saline bag (normally 100mL bag).
For example, if the ordered dose of Actemra is equivalent to 24mL, then remove 24mL of saline from bag.
Draw up Actemra from the vial(s) to get the ordered dose.Â
Actemra is weight based and therefore dose will vary patient to patient.
Add Actemra to your saline bag and mix gently.
ADMINISTRATION
Take baseline vitals and document basic assessment.
Spike the bag of Actemra & prime line.
Infuse Actemra over 1 hour or per order.
Record vitals every 15 minutes after infusion start AND 5-10 minutes post infusion.
Record lot numbers and expiration dates for vials used.
Disconnect patient, flush line, and remove IV.
Place pressure bandage at site.Â
Clean and dispose of used supplies.