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Second Opinions > Adding epinephrine to BSS?

Adding epinephrine to BSS?

Does anyone add epinephrine to the 500ml bottles of BSS for cataract phacoemulsification cases? Alcon doesn't support additions to this solution. Has anyone else stopped this practice based on these directions?

Started by: Debbie Goodman (OR Manager/Supervisor) at September 4, 2012 (11:50 am)

Comments and Responses

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Because of the restricitions on medication compounding we have given up adding epinephrine to the BSS. I never thouhgt the surgeons could do without the Epi in the BSS but we have found that the majority of time the pupil is sufficiently dilated with topical dilating drops. Occassionally a physican may request Intracamaral Epinephrine. This is drawn up at the time it is used.
I Kelly, RN (Dir of Regulatory Compliance, ASC)
Barnet Dulaney Perkins Eye Center

I. Kelly (Administrator/Director/Manager/Owner/Exec. Officer) at June 20, 2013 (12:57 pm)

One of our eye surgeons showed a copy of the BSS bottle label to Dr. Nick Mamalis from the Moran Eye Center at U of Utah re: no additives. Dr. Mamalis has been one of the tope researchers on TASS. Dr. Mamalis said that verbiage was put on the BSS bottle label back when there was BSS Plus and that required an additive. This bottle was not the BSS Plus and therefore was not to have the additive. He said there is not a problem with adding epi or Vanc and said we could quote him.

Shirley R. (OR Manager/Supervisor) at June 19, 2013 (2:12 pm)

One of our eye surgeons showed a copy of the BSS bottle label to Dr. Nick Mamalis from the Moran Eye Center at U of Utah re: no additives. Dr. Mamalis has been one of the top researchers on TASS. Dr. Mamalis said that verbiage was put on the BSS bottle label back when there was BSS Plus and that required an additive. This bottle was not the BSS Plus and therefore was not to have the additive. He said there is not a problem with adding epi or Vanc and said we could quote him.

Shirley R. (OR Manager/Supervisor) at June 19, 2013 (2:10 pm) [last edited on June 19, 2013 (2:11 pm)]

We still do but I would love to know more about this. Do you have more information?

Vanessa Lyons (OR Manager/Supervisor) at June 19, 2013 (12:44 pm)

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Thank you, useful.

Thank you, useful

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carrcarr10 ken (Administrator/Director/Manager/Owner/Exec. Officer) at May 12, 2013 (0:59 am)

Things to consider when shopping for the best hard disk drives
If you are shopping for the best laptop hard drive, you're going to have your work cut out for you, especially buy laptop hard drive online. Finding a reliable hard drive to purchase is not going to be as easy as 123. You may have to spend some time looking around on the Internet and doing some comparison shopping so that you can find a hard disk for sale that will satisfy your expectations and meet your needs as well, before you make a determine you can just know about the laptop hard drive cost in the field. Using a laptop means that you're going to need enough space to store your files, install your software and do everything that you want to do on the computer. There a lot of things to consider when you purchase a new hard drive for your laptop. Below, you will find with some of these things are and why it's important to shop around for hard disk drives for sale so that you can find the precise laptop hard drive that you want to buy.

1,Look for a hard disk drive that has enough space to meet your needs
Knowing how much space you need on your hard drive can be a difficult thing. Often times, people don't think they need much space but then they come to realize that they needed more than they originally thought. For instance, some people think that they just need to purchase a hard drive that is going to cover their files. For instance, if they have about 10 gigabytes of files, they may purchase just a 20 to 40 gigabyte hard drive. The problem with this is that you are not accounting for the operating system. If you plan to run an operating system like Linux or Windows on the computer, then you need to purchase a hard drive that has enough space to properly run the operating system and store your files. There are other things to keep in mind as well, for instance, what software are you going to be putting on the computer? Software can take up a lot of space on a computer, especially games and software that is very complex. These types of software titles can get up into several gigabytes of space, so you need to have a big enough hard drive to accommodate for these applications.

2,Remember that it's okay to go over what you need but it's not okay to go under
Of course, you can easily see there are so many laptop hard drive for sale online, when purchasing a hard drive, it's okay to purchase more gigabytes than you actually need, just like me, I love installing lots of games, so I bought a big sony laptop hard drive in advance. However, if you were to purchase less gigabytes than you actually need, this is not going to be okay because you won't be able to do the things that you want to do on your computer. Be sure to shoot for more disk space. Keep in mind that installing a hard drive on a laptop can be more complicated than installing a hard drive on a desktop computer. You also need to accommodate for the installation costs when you're going to have a company install this for you. Look online and do some comparison shopping so that you can find the best laptop hard drive for a price that makes sense for your budget.

Need more info about laptop hard drives or purchasing, please go harddrivestore.org


Thank you, useful.

Thank you, useful

But to be frank, it doesn't tell in detail what should we do to choose a best one, agree?

I don't think it's good to buy a new hard dirve, why not change the laptop? Lol.

carrcarr10 ken (Administrator/Director/Manager/Owner/Exec. Officer) at May 12, 2013 (0:58 am)

We are still using epinepherine and are unable to get the preservative free. Reading this, I am going to approach the surgeons in this area. Have you seen any literature on the discontinuation?

Regina Blount (Director, Surgical Services/Director of Nursing) at March 11, 2013 (3:57 pm)

We still add Epi to our BSS

Rita J. (Director, Surgical Services/Director of Nursing) at February 21, 2013 (1:54 pm)

We currently add Preservative Free .3ml epinephrine (1mg/ml) 1:1000 per 500 ml Bottle of BSS Plus for every Cataract Procedure. Does it matter? It is suppose to keep the iris dilated longer. However, it is hard to tell when a procedure typically only lasts 30 minutes. With patients on Flomax, it does not make much of a difference it seems. We end up using iris retractors of some sort to mechanically dilate the pupil usually.

Richard S. (Other) at February 21, 2013 (12:57 pm)

Since we can no longer get the perservative free epinephrine 1:1000; we have stopped adding it to the BSS. We have not noticed any difference.

Barbara Marco (Administrator/Director/Manager/Owner/Exec. Officer) at December 21, 2012 (3:40 pm)

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