Does Normal Saline "expire"??

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    In a bit of a bind here. I am taking a trip to Africa to assist in Surgery in May. I've put out a call for donations of supplies etc, and have gotten some things, and some more are coming. Today, a nice lady donated 2 big boxes of 0.9% NS in 250 ml bags, perfect for hanging our preop abx, but the have an Exp date of 12/02. I called Baxter, who made them and they immediately told me to throw them out and they would sell me more and that the normal saline would "break down". (When I asked the guy what it would break down into he was at a loss for words, and actually said, Ummm, uh it will just degrade.) Being a bit confused, I called my pharmacist buddy and she said, "Normal saline is just normal saline, it can't degrade like mannitol". SO now, I'm torn. Does the stuff really expire? It has no chunks or flecks floating in it, and it is clear and not discolored. It is all still in sterile wrapping around the bags as well. What do you think?

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  2. 16 Comments...

  3. 0
    If any one element of what's in there can degrade or change (maybe the plastic bag leaches something into the saline?) then it has to have an expiration date. Other than that, I don't know.
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    I know that our expired endotracheal tubes have to be replaced, even though they're just inactive latex or similar. When I asked our supplier (a trusted colleague for 13 years, not a sleazy company rep) why, she said that they are no longer guaranteed to be sterile after the expiration date.
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    Wasn't there a media expose recently concerning pharmaceutical companies that put early expiration dates on their supplies, not to protect the public, but to increase orders? The real expiration dates of many, many items sampled were years away from those printed on the items.

    This sort of dilemma is typical of working in charitable situations. Sometimes the choices are obvious - I was once given huge quantities of a food substance nine years out of date for an orphanage! That was an easy call.

    Can you ask for a team decision on these sort of issues?

    So often it will come down to the RNs best judgement. Remember Florence and "first do no harm."
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    It says it is expired. I would not choose to take someones well-being on a guess of phrarmaceutical greediness.
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    I know that Doctors Without Borders won't take expired medical supplies as donations, so I suspect there are legitimate reasons for the product dating.
  8. 0
    I'm definitely going to ask the surgeon what he wants to do with it- I don't want to have the weight if it won't be used. There was that media expose- I think maybe 60 min? But the situation was that many of the dates on the items are like Milk- a sell by date, rather than a use by date. The milk is still good for 5 or 6 days after. But, I have wondered about the plastic leaching into the saline- which is why I'm told not to warm NS in the microwave....
    My instinct is to throw it away, but then part of me just keeps wondering, I think I'll try to get some from another source... and keep poking around the drug rep corner for what actually degrades in NS. If it were a case of expired levaquin, I'd know what to do!!!!!!
    Plus you know, I still have to send this lady a nice note, and though the stuff may be good this is really what I want to say and if I can get away with it, I might.

    Thank you so much for your charitable contribution of an item which legally can not be used anywhere in United States Health Care. It touches my heart that you care enough to send items especially chosen to show how you feel about these people. They are sure to understand your esimation of their value in this world by your gift.... Etc etc etc. ok, don't get me started.
  9. 0
    Sure would be nice if Baxter were to replace it for the good will it would generate for them......did you ask? Perhaps Abbott or Travenol would be interested.
  10. 0
    I understand the impulse though. We can return SOME expired supplies for credit, but a lot of items can't be returned and we just eat the cost. It kills me to throw away perfectly good IV solution and ACLS drugs because they're, like, 1 minute expired. My company donates a lot of expired stuff to 3rd-world countries too.

    Our supplier has always told us that it's generally accepted knowledge in the pharmaceutical biz that meds are still fine for 6 - 12 months past the printed expiration date, if that helps you any.
  11. 0
    In case you find out that this NS is not useable I have a suggestion regarding what to do it. Donate it to your local community or state nursing college. When I was in nursing school the local hospitals donated expired NS (among other items) bags so that we as students could practice priming the tubing, etc. The instructors would use hemostats to seal the bags to prevent leakage between uses. Just a thought,....


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