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Faxed prescriptions will only be accepted from a prescribing practitioner. Prescribers are reminded patients may choose any pharmacy of their choice. Intravenous Immune Globulin (IVG) Referral Form
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How to fill out intravenous immune globulin ivig

How to fill out intravenous immune globulin ivig
01
To fill out intravenous immune globulin (IVIG), follow these steps:
02
Gather all necessary supplies, including IVIG solution, IV tubing, sterile needles, alcohol wipes, and gloves.
03
Wash your hands thoroughly and put on a pair of gloves.
04
Check the IVIG solution for any discoloration or particles. Do not use if the solution appears abnormal.
05
Use an alcohol wipe to clean the injection port of the IV bag.
06
Remove the protective covers from the sterile needle and IV tubing, being careful not to touch the ends.
07
Insert the sterile needle into the injection port of the IV bag and secure it in place.
08
Connect the other end of the IV tubing to the infusion pump or gravity drip system.
09
Prime the tubing by allowing the IVIG solution to flow through and remove any air bubbles.
10
Determine the prescribed rate of infusion and set the appropriate flow rate on the infusion pump or adjust the height of the IV bag for gravity drip.
11
Once everything is set up, start the infusion by pressing the appropriate button on the pump or opening the clamp on the IV tubing for gravity drip.
12
Monitor the flow rate and the patient for any adverse reactions during the infusion.
13
After the infusion is complete, dispose of all used supplies properly and wash your hands again.
Who needs intravenous immune globulin ivig?
01
Intravenous immune globulin (IVIG) is typically prescribed for individuals who require passive immunity or have immune deficiencies.
02
The following individuals may need IVIG:
03
- People with primary immunodeficiency disorders (such as X-linked agammaglobulinemia, common variable immunodeficiency, or severe combined immunodeficiency) who are unable to produce enough antibodies.
04
- Patients with autoimmune disorders, including immune thrombocytopenic purpura (ITP), Kawasaki disease, or systemic lupus erythematosus (SLE), to modulate their immune response.
05
- Those with certain neurological conditions like chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy (MMN), or myasthenia gravis.
06
- Individuals with certain infections, including primary immunodeficiency-related infections, viral infections in immunocompromised patients, or bacterial infections like streptococcal necrotizing fasciitis.
07
However, it is essential to consult a healthcare professional to determine whether IVIG is suitable for a specific individual's condition.
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What is intravenous immune globulin ivig?
Intravenous immune globulin (IVIG) is a solution of human antibodies that can be used to treat a variety of immune system disorders.
Who is required to file intravenous immune globulin ivig?
Healthcare providers and facilities are required to file intravenous immune globulin IVIG claims for reimbursement purposes.
How to fill out intravenous immune globulin ivig?
To fill out intravenous immune globulin IVIG forms, providers must include patient information, dosage administered, and any supportive documentation.
What is the purpose of intravenous immune globulin ivig?
The purpose of intravenous immune globulin IVIG is to boost the immune system and provide antibodies to individuals who have immune deficiencies.
What information must be reported on intravenous immune globulin ivig?
Information that must be reported on intravenous immune globulin IVIG includes patient demographics, treatment dates, dosage administered, and healthcare provider information.
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