Protocol Index	

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RESEARCH CTL H-31973 AH MED ICAR 	

Types:      Research Oncology Treatment, ONCOLOGY SUPPORTIVE CARE
Synonyms:  RESEARCH, CTL, H-31973, H31973, 31973, AH MED, ICAR, AHMED

Infusion 1	Repeat 1 time	Cycle length: 2 days	Day -1	Perform every 1 day x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Nursing Orders
  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	OK TO USE	Interval: --	Occurrences: --		  	ACCESS PORTACATH	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	For female patients of child bearing potential.
				Day 0	Perform every 1 day x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Nursing Orders
  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	(Include breath sounds) Pre-Infusion and During Infusion.  

Starting Post Infusion:  Monitor Every 30 minutes x 2, Then Every 1 hour x 3.  

(Total monitoring period Post Infusion is 4 hours).
		  	RESEARCH -  PULSE OXIMETRY	Interval: --	Occurrences: --	Comments:	Continuous Pulse Oximetry for Oxygen Saturation levels GREATER than 90% During, and at least 30 minutes Post-Infusion.
		  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --	Comments:	Start peripheral IV, if no central line. Use 3-way stopcock and tubing.
		  	RESEARCH - SUPPLIES/KIT TO BEDSIDE	Interval: --	Occurrences: --	Comments:	Must be at bedside prior to infusion: Oxygen and suction set up, normal saline flushes, red caps, and syringes with needles (1mL and 3 mL).
		  	RESEARCH - ASSESS	Interval: --	Occurrences: --	Comments:	Patient for immediate reactions: 1) Allergic reactions (anaphylaxis) 2) Decreased oxygenation (due to migration of lymphocytes to lungs).
			Nursing Orders
  	NEURO CHECKS	Interval: --	Occurrences: --	Comments:	Neuro Checks per Protocol.
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	For female patients of child bearing potential.
			Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Hydration
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose			Offset: 0 Hours	Instructions:	Give 30 minutes prior to product administration.			Nursing Orders
  	ONC NURSING COMMUNICATION 100	Interval: --	Occurrences: --	Comments:	Cells to be administered by physician per neurosurgery (generally by syringe injection with 0.9% Normal Saline flush).

Verify cell dose and patient information on Component Infusion Form. Record infusion start and stop time on form and place in patient's medical record.

Clinic nurse to remain at bedside during the entire infusion.

Ensure informed consent is obtained.
			Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --			Emergency Medications
  	TRANSFUSION REACTION EVALUATION	Interval: Once	Occurrences: --	Comments:	Emergency Medications: Anaphylactic precautions: Keep medications at the bedside to administer per physician's orders.
		  	diphenhydrAMINE (BENADRYL) injection 50 mg	Dose: 50 mg	Route: intravenous	once PRN	Start: S			Instructions:	Keep at the bedside to administer per physician's orders.		  	hydrocortisone sodium succinate (Solu-CORTEF) injection 250 mg	Dose: 250 mg	Route: intravenous	once PRN	Start: S			Instructions:	Keep at the bedside to administer per physician's orders.		  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	once PRN	Start: S			Instructions:	Keep at the bedside to administer per physician's orders.			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.