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FAX completed form to ARJ 8774518955 Intake Specialist 8664518804 referral@arjinfusion.com arjinfusion.com/referralsAdult Intravenous Immune Globulin (IVG) I Order Form Patient Name: ___Date: ___SSN#:___

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How to fill out pediatric intravenous immune globulin

01

Wash hands thoroughly before handling equipment.

02

Check the expiration date on the immune globulin bottle.

03

Prepare a clean surface for assembling the equipment.

04

Use a sterile syringe and needle to withdraw the appropriate amount of immune globulin from the bottle.

05

Administer the immune globulin slowly into the patient's vein according to the prescribed dose and schedule.

Who needs pediatric intravenous immune globulin?

01

Pediatric patients who have immune deficiencies and require supplementation with immunoglobulins to help fight off infections.

02

Children with autoimmune diseases or certain neurological disorders that can benefit from the immune modulating properties of intravenous immune globulins.

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What is pediatric intravenous immune globulin?

Pediatric intravenous immune globulin is a treatment that provides antibodies to help boost the immune system in children.

Who is required to file pediatric intravenous immune globulin?

Healthcare providers who administer pediatric intravenous immune globulin are required to file the necessary documentation.

How to fill out pediatric intravenous immune globulin?

Pediatric intravenous immune globulin can be filled out by including information such as patient demographics, dosage administered, and adverse reactions.

What is the purpose of pediatric intravenous immune globulin?

The purpose of pediatric intravenous immune globulin is to provide passive immunity and prevent infections in children with weakened immune systems.

What information must be reported on pediatric intravenous immune globulin?

Information such as patient name, date of birth, healthcare provider administering the treatment, dosage, and any adverse reactions must be reported on pediatric intravenous immune globulin.

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