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DR. CRANTON'S WRITTEN ORDERS FOR NURSES TO 
ADMINISTER INTRAVENOUS EDTA CHELATION THERAPY

Patient Name ______________________________________

Date ______________

1.  Measure body weight, blood pressure and pulse with each infusion.

2. Serum creatinine is to be drawn prior to each third infusion if EDTA chelation is infused from one or two times per week.  Measure serum creatinine with each infusion if EDTA is infused 3 or more times per week, if prior serum creatinine was previously above the normal range or if an upward trend has been noted.

3.  Notify physician before starting infusion of any consistent upward trend of serum creatinine toward or above the upper limits of the reference range.

4. Urine analysis (dip) will be done with each infusion.  Notify physician of any suspected abnormalities.

5.  Notify physician of any weight gain of more than 5 lbs. since last infusion, diastolic BP >100, or systolic >160.

6.  Notify physician of any unusual situation.

7.  If weakness or dizziness occur during infusion, elevate feet and lower head of patient.  If symptoms persist, substitute normal saline for EDTA infusion, draw blood for calcium and electrolytes, measure whole blood glucose with glucometer, monitor frequent vital signs and notify physician .

8.  Ensure that juice and other nutritious snacks are available for any patient who might develop symptoms of hypoglycemia, or has not eaten within 3 hours prior to each infusion.

9.  Inquire of each patient about improvements, complications, or symptoms following or since their last infusion.  Record in chart and notify physician of any significant changes.

      10.  Notify physician of patients who routinely take Lasix (furosemide) or any other diuretic for congestive heart failure who shows signs of dependent edema or shortness of breath.  If physician’s orders furosemide by intravenous push, administer slowly over 2 minutes at the beginning of chelation EDTA infusion in the same IV tubing.

11.  The chelation staff will be thoroughly familiar with the provisions of the PROTOCOL FOR ADMINISTRATION of EDTA CHELATION THERAPY, published as chapter 32 in the Textbook on EDTA chelation Therapy, Second Edition.  A copy will be present in the physician’s office, and at the nurse’s station.

12.  Compute the dose of EDTA for each infusion using the formula according to instructions below.  (click her for formula) A computer program is available in the clinic to simplify these computations.  After the 3rd infusion, if serum creatinine has been within the reference range relatively stable (plus or minus 20%), each subsequent infusion may be mixed and started using the average of the prior several creatinine measurements.  If serum creatinine shows an upward trend, mix and start the next infusion using a revised dose, computed using the current serum creatinine.  Serum creatinine measurements should be performed before each infusion if an upward trend is noted.  In no event will the dose of EDTA exceed 3 Grams without specific Physician’s orders.

13. Unless previously modified by physician, mix each EDTA infusion bottle according to instructions below.

14.  If a "clear solution" is ordered by the physician for a patient who might show intolerance or allergy to one of the customary ingredients, use an isotonic carrier solution of normal saline or 5% dextrose in water, according to instructions below. (click here for detail)

15. Remind patients to continue taking their daily nutritional supplements to prevent depletion by chelation therapy and to enhance overall benefits. Document supplement copmpliance in chart, and notify the physician of non-compliance.  Inquire of about any change in prescription medicines and  record any change in their chart. Remind patients to not take trace element supplements on the day of chelation until after the chelation treatment.

Physician's signature____________________________________Date______________

---------------------------------------------

Clear Solution

When patients experience side effects ( headache, itching, fatigue, etc.) following chelation therapy, a hypoallergenic "clear solution" can be used for subsequent treatments. This formula might also be used from the outset for patients who are known to be chemically sensitive. It is called the "clear solution" because it has has no colored tint from B-vitamins. A carrier solution Isotonic Normal Saline or 5% Dextrose in Water (D5W) is used. Remove 30cc, and then add only four ingredients: 1) the computed dose of EDTA, 2) MgSO4, 3) Sodium Bicarbonate, and 4) Lidocaine, with the strengths and amounts for those four ingredients as listed above.

Simplified protocol for doctors outside the USA with limited access to all ingredients listed above: 

For several decades, from the early 1950s through the mid 1980s, EDTA chelation therapy consisted very simply of 3.0 grams disodium EDTA, infused over three hours in a 500 ml solution of either 5 percent dextrose in water, normal saline, half normal saline, or Ringer’s lactate solution.  Lidocaine or procaine was added to prevent pain at the infusion site.  Minimal vitamin supplements were given by mouth.  For treatment of patients with relatively normal renal function, that minimum protocol will work very well. For many years all published reports of EDTA chelation’s success were derived using this simpler protocol. The active ingredient is disodium EDTA. The goal is to get the prescribed dose of EDTA into the patient slowly over 3 hours without discomfort.

COCKCROFT-GAULT EQUATION, MODIFIED FOR DOSE OF EDTA

This formula will result in approximately the same blood level of EDTA throughout the IV infusion for all patients by adjusting for the effects of age, sex, body size and composition and kidney clearance rate.

_________________________

Glomerular Filtration Rate Computation

CLICK HERE For a Microsoft Excel Macro that calculates EDTA Dose using the protocol described above.
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MAGNESIUM SULFATE AND SODIUM BICARBONATE MIXING TABLES

Last modified: May 20, 2008 6:24 AM

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