|
Original version Date: 2014
|
| bet | 267/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
| Original version Date: 2014
|
Author: NMF Consensus Group
|
Current Version number: 2
|
Current Version Date: 14/1/2021
|
Risk Rating: Low
|
Due for Review: 14/1/2026
|
Approval by: DTC
|
Approval Date: TBA
|
| Heparin CVC Lock |
|
Revision Date : 28-2-2021
|
Approved : DD, TC, KOH
|
Indication :
|
To maintain patency of secondary lumens on central venous catheters and to allow blood sampling from central line
|
Dose :
|
Time between access:
1] < 6 hours – 1.5 mls - Normal saline
2] < 24 hours – 2 mls daily – 50 units heparin in 5 mls
3] > 24 hours – 2 mls weekly – 1000 units heparin in 10 mls
|
Interval :
|
1] 4-6/24
2] daily
3] weekly
|
Route :
|
IV
|
Total Daily Dose :
|
|
Comments :
|
Always remove heparin lock before accessing the catheter to ensure heparin is not injected into the patient and to remove previous heparin lock before administration of next heparin lock. All clamping is to be done on the cuffed area of the tube.
|
Supplied as :
|
1] Normal saline 10 ml ampoule
2] 50 units heparin in 5 ml ampoule
3] 1000 units in 1ml ampoule
|
Dilution :
|
1] Normal saline 10 ml ampoule – no dilution required
2] 50 units heparin in 5 ml ampoule – no dilution required
3] 1000 units in 1ml ampoule – dilute 1 ml ampoule with 9 mls of normal saline (100 units per ml)
|
Stability :
|
Discard unused portion.
|
Storage :
|
Room temperature
|
Compatibility:
|
|
Incompatibility :
|
|
Serum Levels :
|
Not required
|
Original version Date: 2014
|
Author: NMF Consensus Group
|
Current Version number: 2
|
Current Version Date: 28/2/2021
|
Risk Rating: Low
|
Due for Review: 28/2/2026
|
Approval by: DTC
|
Approval Date: TBA
|
Hepatitis B Immunoglobulin |
Revision Date : 15-12-2020
|
Approved: TC, KOH
|
Indication
|
Passive immunisation of newborns whose mothers have acute hepatitis B infection at the time of delivery or who are hepatitis B surface antigen (HBsAg) positive.1
|
Action
|
Confers immediate passive immunity due to the injection of pre-formed antibodies.
|
Drug Type
|
Immunoglobulin.
|
Trade Name
|
Hepatitis B Immunoglobulin-VF2
|
Presentation
|
100 Unit/mL ampoule.
Available from the blood bank.
|
Dosage/Interval
|
100 Units single dose.
|
Route
|
IM ONLY in the anterolateral thigh.
|
Administration
|
Administer as a separate injection within 12 hours after birth at the same time as the hepatitis B vaccine (should be given in the other thigh).
Efficacy decreases > 48 hours from birth.
DO NOT ADMINISTER IV because of the risk of serious systemic reactions.
Record details of the vaccination in patient's Personal Health Record ("Blue Book").
Record batch number on the medication chart.
Record injection sites of concurrently administered vaccines to allow any local reactions to be attributed to the appropriate antigen.
|
Monitoring
|
Monitor injection site.
Hepatitis B surface antibodies (anti-HBs) and HBsAg concentrations should be measured in infants born to mothers with chronic hepatitis B infection 3 to 12 months after completing the primary vaccine course. Testing should not be performed before 9 months of age to avoid detection of anti-HBs from hepatitis B immunoglobulin given at birth. If anti-HBs levels are adequate (≥ 10 mUnit/mL) and HBsAg is negative, then the infant is considered to be protected.
|
Contraindications
|
Severe thrombocytopenia or bleeding disorder.
Isolated IgA deficiency.
|
Adverse Reactions
|
Local pain and tenderness at injection site.
Systemic reactions are rare but may include urticaria, angioedema, erythema, low grade fever.
|
Storage
|
Store between 2 and 8°C. Do not freeze. Protect from light.
|
Special Comments
|
Three subsequent doses of a multivalent/combination hepatitis B vaccine should be given
at 6 weeks, 4 months and 6 months of age, so that the infant is given a total of 4 doses of
hepatitis B-containing vaccines. For babies born at <32 weeks gestation and/or <2000g, a
booster dose is also given at 12 months unless serology confirms infant is protected (see
monitoring).1
Use cautiously in patients with thrombocytopenia, coagulopathy or bleeding disorders who
may be at risk of haemorrhage from IM injection.
If the mother has a known blood borne virus, clean the limbs prior to administration
|
Evidence summary
|
In a meta-analysis of three randomized trials, compared with placebo/no intervention, the combination of HepB vaccine and HBIG reduced HBV infection in infants born to HBsAg-positive women (4 versus 57 percent, relative risk [RR] 0.08, 95% CI 0.03-0.17)3
In prospective surveillance studies of infants born to women with HBV infection who received HBIG and HepB vaccine and had postvaccination serologic testing, perinatal HBV infection occurred in <2 percent.4, 5
|
References
|
The Australian Immunisation Handbook. https://immunisationhandbook.health.gov.au/about-the-handbook. Accessed 15-12-2020
MIMS Australia, Hepatitis B Immunoglobulin-VF full product information (Accessed 15-12-2020).
Lee C, Gong Y, Brok J, et al. Hepatitis B immunisation for newborn infants of hepatitis B surface antigen-positive mothers. Cochrane Database Syst Rev 2006; :CD004790.
Schillie S, Walker T, Veselsky S, et al. Outcomes of infants born to women infected with hepatitis B. Pediatrics 2015; 135:e1141.
Centers for Disease Control and Prevention (CDC). Postvaccination serologic testing results for infants aged ≤24 months exposed to hepatitis B virus at birth: United States, 2008-2011. MMWR Morb Mortal Wkly Rep 2012; 61:768.
|
Original version Date: 8/8/2015
|
Author: NMF Consensus Group/TC
|
Current Version number: 2
|
Current Version Date: 21/12/2020
|
Risk Rating: Low
|
Due for Review: 21/12/2025
|
Approval by: DTC
|
Approval Date: TBA
|
| |
