Western Maryland Health System Physician Orders Doctors Orders Intravenous Immune Globulin (Ivig) For Adults And Pediatrics Page 2

4. NURSING GUIDELINES:

IVIG must be infused through a 15 micron filter to avoid infusion of particulate matter and is dispensed

with the IV tubing.

IVIG should be infused into a large vein in a separate infusion line with no other medication; if using a

primary line, flush the line prior to administration.

If infusion-related reactions occur (flushing, changes in heart rate or blood pressure, generalized

urticaria, angioedema, respiratory distress) stop infusion and call the physician

Physician/Date/Time:

Nurse/Date/Time:

Secretary/Date/Time:

Full page of orders requires only one physician, one nurse and one clerical signature

Original to Patient’s Chart

Fax to Pharmacy

Original: 9/11

Revised: 7/14; 9/14;11/14

Reviewed: 9/11;12/13

Form: 1.0-003

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Parent category: Business