Description

• Clear solution 100 micrograms in 2 ml ampoules.
• 500 micrograms in 10 ml ampoules.
• Each ml contains sodium hydroxide for pH adjustment. pH 4-7.5.

• Individual doses are charted on stat page of prescription chart in micrograms/dose.
• Maintenance doses are charted on the prescription chart in micrograms/dose.

Continuous infusions are charted on fluid chart giving:

• rate in ml/hour
• dose in micrograms/kg/hour

Also charted on drug chart under continuous infusions giving:

• amount of drug to be added
• base fluid, type and volume
• micrograms/kg/ml

Administration

Administered by nursing staff except the first dose in the nonventilated perioperative neonate.

1. Administer by slow IV injection over 3-5 minutes. Filter prior to administration through a Pall 0.2 micron filter.
2. Is compatible with D5W and NS. Compatible with IVN at the Y-site.
3. Do not mix with other drugs or blood products.
4. Flush before and after administration of fentanyl with NS.

1. Administer by slow IV infusion over 1 hour using a syringe pump. Filter prior to administration through a Pall 0.22 micron filter.
2. Is compatible with D5W and NS. No data available on dobutamine and dopamine.
3. Do not mix with other drugs or blood products.
4. Flush before and after administration of fentanyl with NS.

1. Dilute prior to administration.
2. Filter prior to administration through a Pall 0.22 micron filter.
3. Is compatible with D5W and NS. No data available on dobutamine and dopamine.
4. Do not mix with other drugs or blood products.
5. Administer via a syringe pump.
6. Change fluid and tubing every 24 hours.

Nursing Considerations

Warning: Rapid IV injection may result in respiratory paralysis.

1. Baby is managed by a Nurse with neonatal IV drug certification.
2. Evaluate baby's need for and response to medication.
3. Assess IV site closely for signs of extravasation.
4. Assess for signs of adverse reactions.
5. Continuous cardiorespiratory and blood pressure monitoring.
6. Monitor oxygen saturations.
7. Monitor respiratory status carefully. Effect on respiration is longer acting that analgesic effect.
8. Ensure naloxone and resuscitation equipment is readily available.
9. Monitor urinary and bladder function.
10. Drug documentation.

• Record baby's dose out of the narcotic register.
• Record balance discarded out of the narcotic register.
• Two nurses must witness the discarding of the unused drug, syringes and ampoules into the sharps container.
• Two nurses must sign FBC when discarding any unused drugs from a continuous IV infusion.

Storage

• Unopened ampoule - store at room temperature in Narcotic Cupboard.
• Protect from light.
• Discard as above once opened.

References