i was was wondering when is it appropriate to use a filter for a continuous infusion D5 1/2 NS kcl? I always put my patient on a filter if
1. They have a cardiac history
2. They have a central line
otherwise I do not use a filter. I am am also aware that some medications require a filter if they are anti neoplastic agents or mannitol. I have never given these medications so therefore never set up a filter.
i was wondering if there are any otger reasons?
the reason I ask is bc I transferred a to picu (I'm an ER nurse) that was high risk for sepsis. Bp was stable but showing signs of early sepsis. This pt had no cardiac hx and no CL. I noticed the PICU nurse stop the infusion when I transported the pt so I became concerned that she though a filter was needed. Any thought? TIA!
Only times I've ever used a filter is when infusing amio, mannitol, or TPN/PPN. There's possibly more but I've always been taught that it is used when there's a high probability that the medication will crystallize once it leaves it's container.
S/he probably stopped the infusion because s/he expected the IV fluid order to change. We in PICUs almost NEVER run D5-1/2 any more due to the really serious complications seen in children caused by hyponatremia. Our standard of care is D5NS or D10NS depending on the age and weight of the patient. We often get kids from the OR running Ringer's or ER running D5-1/2 and switch them over ASAP. Even for central lines and kiddos with cardiac history, we don't filter anything that doesn't REQUIRE filtering. Amio, phenytoin, some of the transplant immunosuppressants, blood products, mannitol, TPN and now lipid emulsions are about it.
She could just be old school, my first job required filters on all IV lines unless contraindicated (albumin, lipids) in case of an undiagnosed cardiac issue. No one could even tell me the reason for the filters other than "that is best practice in pediatrics" which isn't true. it's really outdated research. A bubble of air in the line won't hurt a healthy infant, they are really only necessary for the reasons everyone else mentioned. That being said, pick your battles. If they want you to use filters on everything just do it. You'll know if it's contraindicated because the medication won't go through the filter.
Must Read Topics