How does SWORBHP suggest measuring the correct dose of Hydroxycobalamin to a pediatric patient? The Cyanokit is provided as vials that are to be reconstituted with normal salient diluent. The pediatric dose is 70mg/kg, given over 30 minutes. Unlike our other pediatric-dosed medications, this system does not allow for us to easily measure the exact dose given as there are no mL markings on the bottles. Sny help is greatly appreciated.
Great question. As you highlight, the vials are not easily measured. An in-line volumetric cylinder (ex. Buretrol) should be utilized to measure out the correct mL dosage of the medication. Per the ALS-PCS Preamble>Conventions>Medication Doses and Administration, Medication doses may require rounding from the exact dose calculated. In these cases, the medication dose delivered will be rounded to the closest dose that can be accurately measured.
Note that the side effects of Hydroxocobalamin are mild (~25% will have a transient increase in BP, may cause nausea and diarrhea, will cause red urine that is transient and not harmful), should the patient receive slightly more than intended due to the inability to accurately measure the dose.
Vitamin B12 (Hydroxocobalamin) CPhA Monograph. Compendium of Pharmaceuticals and Specialties, online version (CPS). Canadian Pharmacists Association (CPhA), 2018.