Iron infusion procedure

IRON INFUSION PROCEDURE
[+] yes, present, positive
[-] no, absent, negative

Simplified dosing calculation:
^ 2 visits at least 7 days apart (maximum dose 1,000 mg per week).
* Recheck iron status before any repeat dosing.
[-] Hb <100 g/L:
  [-] Body weight 35-69 kg -> 1,500 mg^
  [-] Body weight 70[+] kg -> 2,000 mg^
[-] Hb 100-139 g/L: 
  [-] Body weight 35-69 kg -> 1,000 mg
  [-] Body weight 70[+] kg -> 1,500 mg^
[-] Hb 140[+] g/L:
  [-] Body weight 35-69 kg -> 500 mg*
  [-] Body weight 70[+] kg -> 500 mg*

Contraindications:
[-] hypersensitivity to infusion component
[-] evidence of iron overload (eg, haemochromatosis, haemosiderosis)
[-] first trimester pregnancy
[-] other:

Consent:
[+] Patient consent obtained.
[+] Possible adverse effects explained, including allergic reaction, anaphylaxis, permanent skin staining and hypophosphataemia.

Intravenous access:
  [-] cannula
  [-] butterfly needle
  Gauge: 
  Location:

Infusion details:
  Agent used:
  [-] ferric derisomaltose
  [-] ferric carboxymaltose
    Dose (mg): 
    batch number: 
    expiry: 
  Saline:
    batch number: 
    expiry: 
    volume (mL):

Observations:
  Pre-infusion:
    IV flowing freely without extravasation (yes/no): 
    Temperature: 
    HR: 
    BP:

5 mins:
    HR: 
    BP: 
    Reactions:

10 mins:
    HR: 
    BP: 
    Reactions:

15 mins:
    HR: 
    BP: 
    Reactions:

20 mins:
    IV flowing freely without extravasation (yes/no): 
    HR: 
    BP: 
    Reactions:

Post-infusion (5 mins):
    HR: 
    BP: 
    Reactions:

Infusion duration (mins):

Post-infusion saline flush: 
  Volume (mL): 
  Evidence of extravasation of injection/infusion (yes/no):

Home care advice:

High phosphorus foods to reduce post-infusion hypophosphataemia:

- cola drinks
- yoghurt
- milk
- eggs
- cheese
- salmon
- scallops
- chicken
- lentils
- cashews
- potatoes
- beans
- brown rice
- whole grains
- peas
- oats

Follow-up investigations:
[+] Iron studies 6 weeks after infusion (CRP, S-ferritin).
[?] FBC 12 weeks after infusion (if anaemic).

Adverse reactions

Manage using your local protocols.

Danger!

Anaphylaxis:

Persistent hypotension OR
Angio-oedema of tongue or airway OR
Involvement of 2 or more of the following organ systems:
- Cardiovascular (eg, hypotension, chest pain)
- Skin (eg, generalised urticaria, non-airway angio-oedema)
- Respiratory (eg, stridor, bronchospasm, hypoxaemia)
- Gastrointestinal (eg, vomiting, abdominal pain)

Warning!

Fishbane reaction:

Flushing
Chest pain
Back pain
Chest tightness with possible dyspnoea

Caution!

Isolated symptoms and signs:

Urticaria
Itching
Rash
Mild hypotension/hypertension
Tachycardia
Nausea
Headache

Iron infusion procedure

Adverse reactions

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