Julius Seizure 1 Article; 2,282 Posts Specializes in Pediatric Critical Care. Sep 26, 2016 Sorry everyone for the lack of clarification.http://saljetrinse.com/images/fourvials.jpg^^^ these are similar to what I'm refering to when I mean NS flushes. We have to draw them up out of those first before administering them. So what we used to do is use a twist-locking syringe to lock onto that, withdraw the 10ml flush, take it off and administer.The new practice I'm asking about it is using a drawing-up needle to withdraw that.how big are those? how many ml?
brillohead, ADN, RN 1,781 Posts Specializes in Cardio-Pulmonary; Med-Surg; Private Duty. Has 5 years experience. Sep 26, 2016 how big are those? how many ml?They are 30ml according to the website. They are also FOR EXTERNAL USE according to the website. Check out this picture at the top of their website:If a facility is using these for IV flushing, that's a HUGE infection risk, IMO -- there's no way to maintain sterility! Not to mention, it says NOT FOR INJECTION right on the unit!If your facility is using these for IV flushes, please stop immediately and discuss with Risk Management!
AliNajaCat 1,035 Posts Sep 26, 2016 There is no harm in reconstituting a Protonix or other med at the bedside and giving it immediately. Changing syringes would serve no purpose. I can see the reasoning when a med is reconstituted for later use, but even so, such a syringe should have an appropriate label added regardless. Why would it matter if it was a "normal saline" syringe or a plain one, if it was labeled?IMeds mixed in a normal saline bag are kept in the original fluid bag, no?They are, but heaven help anyone who adds something to it and doesn't label it. I think the concern c the flushes is that you might, in a moment of distraction or emergency, put that "flush" in your pocket and then give the med in it to somebody else.
Guest219794 2,453 Posts Sep 28, 2016 This is a good point. Additionally, once you squirt out the saline into a vial for reconstitution of a med, drawing it back up into the same syringe is technically a break in sterility, as the inside of the syringe is no longer sterile because the plunger has been pushed in, exposing the inside of the syringe to the outside.We used to (years ago) hook up versed bags to patients with a syringe in the middle (similar to an anesthesia set up for pushing blood or fluids) so that we could draw up from the bag and run the med on a syringe pump. We would use the same syringe repeatedly to draw up more med - till someone realized how unsterile and gross that was. Now, new syringes every time.So- when the plunger is depressed, the barrel is exposed to room air. Just like everything in a sterile field is exposed to room air. Why is this a problem? How can you draw any med into any syringe without exposing the inside of the syringe to the outside? I must be missing something here.Regarding some other posts- Yup, drugs in an unlabeled flush are dangerous. As are drugs in an unlabeled 50 ml bag, an unlabeled syringe, or an unlabeled anything.
TheCommuter, BSN, RN 226 Articles; 27,608 Posts Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 17 years experience. Sep 28, 2016 Moved to the Nursing and Patient Medications forum.
bcallahan121 2 Posts Oct 1, 2016 that's completely backwards. if you draw up NS from a bag using a 10mL wrapped sterile syringe with needle, then discard the needle, and then use the syringe to flush the line, you are exposing the point of contact to air for at least twice as long as if you use a pre-filled 10mL syringe for flushing, where you simply remove the whole from the plastic wrap (still sterile at this point), screw off the cap, and immediately apply it to the port that you've hit with an alcohol pad. furthermore, the aforementioned bag of NS has probably been accessed more than once so the infection risk rises by a factor of one each time it is used, again, due to repeated exposure to environmental air.
bcallahan121 2 Posts Oct 1, 2016 There is another alert by ISMP that has more detail about the misuse of Saline prefills.I have it on my computer at work and will find it and post it.The IFUS for prefills state that the product is only be used for IV catheter flushing.It is a one time use as well.You can not use 5 ml...save it and cap it and then use the remaining 5 ml later.You need to use it and discard it and the cap that covers the end should not be used to cover IV tubing either.THIS.
