IV vs IM Rho (D) Immune Globulin

[MId West Banker 0]

I have an OB Physician inquiring about giving Rho (D) Immune Globulin IV instead of IM and no reason was given for this request. Does anyone have any information regarding this subject?

 

[David Saikin 1,425]

There is intravenous RhIg available.  You would have to look at your product to see if it as able to be given iv.

I would assume the MD feels it would be more comfortable to the patient if given through an already patent iv.

[LIMPER55 20]

mostly given IV cuz reimbursement is greater from insurance than I'm

[Neil Blumberg 246]

IM injections hurt. IV hurt much less.  Both acutely and over the next day or two.  That's the likely motivation.  Most physicians don't administer IV meds in their office as it requires more time and skill.

[Baby Banker 84]

IM injections of a viscous material are traumatic.  This made IV Rh Immune Globulin IM injections less desirable for a thrombocytopenic  Rh negative female being given Rh positive platelets.

[BankerGirl 212]

I don't know about all Rh Immune globulin preparations, but Rhophylac cannot be given IV for Antepartum prophylaxis.  It is cleared too quickly if given IV and doesn't protect the mom through to delivery.  For our postpartum patients, however, the IV administration is huge for patient satisfaction.

[Joanne P. Scannell 219]

We switched to Rhophylac here in the hospital because 'everyone' likes having the option of giving the dose IM or IV.

The MD's are still using RhoGam (no IV option) for their office injections (IM Only), e.g. Antenatal/Antepartum dose.

[AMcCord 1,281]

3 hours ago, Joanne P. Scannell said:

We switched to Rhophylac here in the hospital because 'everyone' likes having the option of giving the dose IM or IV.

The MD's are still using RhoGam (no IV option) for their office injections (IM Only), e.g. Antenatal/Antepartum dose.

Ditto for us. It was actually nurse driven for patient satisfaction. The providers didn't care one way or the other except they weren't going to sign off on it if it cost more than RhoGAM. The only kicker is that the IVs are not discontinued as soon as they were when IM RhoGAM was administered. If the patient wants the IV out NOW, then they get the Rhophylac IM - their choice. We've had no issues.

[ksmith 13]

We give mostly IV RhIg post-partum.  I learned this because we started to get calls from nursing stating the Post Partum testing is STAT and where are the results.  If I have the specimen collected, I don't consider that testing STAT especially when I have other patients needing blood products.  Obviously, they want to give the RhIg so they can remove the patient's IV.  

[AMcCord 1,281]

On 8/12/2020 at 11:16 AM, ksmith said:

We give mostly IV RhIg post-partum.  I learned this because we started to get calls from nursing stating the Post Partum testing is STAT and where are the results.  If I have the specimen collected, I don't consider that testing STAT especially when I have other patients needing blood products.  Obviously, they want to give the RhIg so they can remove the patient's IV.  

When we made the switch to Rhophylac, I made sure that there was a clear understanding that we would not be doing the workups STAT. They've been good about it. Once in a while they call and ask for a time estimate because a patient is getting anxious about the IV, but it's just for info, not pushing.