Puncturing Luer Valve?

[jameyrn31]

Hey there,

Encountered something odd today. I work at a clinic where administer IV infusions. Patient presented with a double lumen, subclavian central line. Neither port seemed to be able to be changed out. Both were luer locks. Infused hub to hub as usual. Patient called the Dr. (my employer) over the weekend saying it wasn't infusing as I had showed her. He had her come in to the office, and proceeded to infuse into a port by accessing it with blunt plastic cannula (alligator clamp). I received a lecture this morning saying that I should have used an alligator clamp. I thought that these luer lock valves are not meant to be punctured at all, that doing so would break the ability for it to self-seal, cause risk for infection/contamination, leaking, exsanguination and gas or air embolus? Any advice? I am having difficulty finding out what type of line and port it was as it was not inserted in our office. I am also having difficulty finding anything online to provide data either way. If you have any advice or links to data that would be helpful.

[lsyorke, RN]

Are you talking about a "Clave" system? These are self sealing and should NEVER be punctured.

[jameyrn31]

Exactly, one of the clave's was white and one was blue. Do you have any links to info or sites that state a clave should never be punctured?

[lsyorke, RN]

I don't have a specific link, but I was taught(way back when these came out) that if the center became "permanently depressed or punctured" a new one should be used, since sterility was compromised.

[lsyorke, RN]

I emailed Baxter(who makes flolink) for an official response. I'll post it here when I hear from them.

[lsyorke, RN]

OK, let me first say that I am extremely impressed with Baxter!! I just got a phone call in response to my email to make sure that all my questions were answered!

Her answer to the "puncturing" of a valve.. is don't do it!!! She said in all of the literature it tells you that "if for any reason the valve is compromised, change the valve". No blunt object(other than a approved connector) should be used with this device.

When in doubt, change the valve!

I hope this answers your question.

[lsyorke, RN]

Bumping for the OP!!!

[jameyrn31]

Thanks so much for your replies and help!! The patient came back to the clinic today. I was able to look at her line/port, it was a Smartsite. In researching this I had found a power point by Smartsite that at nearly the bottom of every page said "The Smartsite port should NEVER be accessed by a needle or blunt cannula!". My coworker and I printed this off, showed it to the MD who got this OMG look on his face and once he realized we did not have any of that brand of cannula at our office RAN to the oncologists down the block to get some caps!! I am not sure what was said to the patient though....