I always used 2ml of 25%.
If it is a nausea issue, keep the room cool.
See references in Ophthalmic Photography [www.TwinChimney.com] Paula
Morris did a superb job in the chapter on Dyes.
Disclosure: I am an author on this textbook.
Thanks,
Marshall
Marshall E Tyler, FOPS
On Mar 10, 2016 7:45 PM, "CPMC Ophthalmic Diagnostic Center" <
cpmceyelab@xxxxxxxxxxxxxxxx> wrote:
Costs? I think a vial is up to a whopping 8.00 at the present time
Isn’t that splitting hairs a bit? Like shorting on the GenTeal when doing
a biometry
Cost of doing business
I cannot see the point of cutting anything in half to save money
The term “Allergic” reaction is sure thrown around lightly. You have to
really ratchet up a normal reaction to the procedure ( vasovagal) or even
mild hives to begin to fill the criteria of a compromised airway, aka
“Allergic”
One hears that term thrown around from everything from gluten to the color
pink. Check out the references and you will see that the peer reviewed
literature on reactions to sodium fluorescein for ophthalmic use are mighty
Slim indeed. Nausea is not an allergic reaction. It’s a contraction
of the large smooth muscle of the stomach more often or not caused by
nerves, clenching, lack of breathing.
Ana, do a literature search on the OPS Website. You will see a number of
articles discussing these issues that have been discussed for four decades
now. AAO’s OMIC group also has a few well worded missives on the subject.
Us old dogs in the field will tell you that PATIENT MANAGEMENT goes a long
way to lessening reactions, not cutting your vial in half.
Respectfully,
Denice
*Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS*
*Ophthalmic Diagnostic Center*
*CPMC Department of Ophthalmology*
*2100 Webster Street Suite 212*
*San Francisco CA 94115*
*(415) 600-3937 <%28415%29%20600-3937> FAX (415) 600-6563
<%28415%29%20600-6563>*
*From:* optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx]
*On Behalf Of *Ana Mills
*Sent:* Thursday, March 10, 2016 2:40 PM
*To:* optimal@xxxxxxxxxxxxx
*Subject:* [optimal] Re: FA dye dosage
Hi Krista,
Ana here, how does your office manager feel about using the 10%
fluorescein? I use the 10% and I always only use 2.5cc for every patient,
to cut costs, and to cut down on the likelihood of an allergic reaction for
the patient. With that combo, I've noticed that it is very rare that I have
patients with nausea/vomiting or itching, etc., which is nice for everyone.
My images very typically still end up being of very high quality, and we
don't blow through our fluorescein supply too quickly. I'm not sure what
the price difference is between the 5% and 10%, but I think you should try
to get your office to start just buying the 10% and always only using 2.5cc
per patient. I've been in the field for five years now, and so far this is
definitely my preferred way of administering the fluorescein injections.
I'm curious to see if they let you switch!
Ana A. Mills
Ophthalmic Photographer/Technician
DC Retina, Dr. Neal Adams, M.D.
2101 Medical Park Drive, Suite 303
Silver Spring, MD 20902
Business phone: (301) 754-1200
On Mar 10, 2016, at 5:27 PM, Krista Peters <krista_81@xxxxxxxxxxx> wrote:
My office manager is wanting to cut costs by lowering the dosage of FA dye
from 5cc to 2.5cc. We are using a 5% dye and currently cut the dosage for
people with renal issues and those images are rarely as good as when using
the full 5cc. My manager is claiming that lots of clinics are doing this.
Do any of you only use 2.5cc with 5%?? I'd be curious to know your thoughts
so I can try to convince the doctors otherwise.
Krista
