Published Feb 1, 2018
ericagrace1101
1 Post
Hi all,
My unit is attempting to trial insuflon catheters for our pediatric cardiac patients requiring lovenox injections. The hold up we encountered is actually the needle/syinge used to draw up the med and inject into the infusion. Insuflon states the injection needle must be between 27-31 gauge. Our pharmacy requires that the needle have a safety device to prevent sticks, and will not allow the use of insulin syringes. Does anyone use the insuflon catheter and know what needle /needle syringe combo you use to inject? If so, I would love some suggestions that I can ask our pharmacy to consider so we can move forward with the trial.
Thanks for the help!!
NotReady4PrimeTime, RN
5 Articles; 7,358 Posts
Our unit and facility thrombosis team did a small-scale study comparing LMWH levels with and without Insuflons a number of years ago. Our patient population includes cardiac surgical, solid organ transplant and trauma; most of our kids have central lines and a number of them develop line-related thromobis - lots of kids on enoxaparin. We used a 1mL hard-body syringe and a BD Eclipse 29g safety needle. I don't recall seeing the published result of the study, but I can tell you we're NOT using Insuflons for LMWH any more. We use an insulin syringe with safety needle and sub-cu injection.
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Burnvegas
27 Posts
We use them, but not for any heparins. But that's mostly because we don't use heparins very often (no cardiac in our unit) and pharmacy got annoyed folk weren't rotating the site so it was a bit outlawed by them.
There does exist insulin needles with a safety device, which we use for the insuflon for insulin
guest940422
1 Article; 195 Posts
You can't use insuflon catheters with insulin syringes, the catheter is longer than the needle and the patient won't get all their insulin. Plus I believe it states in the literature that comes with the catheter it isn't compatible with insulin
They make safety tb syringes you can administer lovenox with that are compatible with the insuflon catheters but I don't know which ones off the top of my head.
I've used insuflon catheters for years at various hospitals.... I hate them! they stay in for a week so you are essentially injecting the medication directly into the exact same tissue for a solid week. When you remove the catheter to rotate the site you will have a giant bruise the size of a tennis ball.
The needle has to be inserted at the perfect angle or you will pierce the side of the catheter and have to change it early, this takes some getting used to so administering your injection goes from a quarter of a second to about 30sec-1min depending on the wiggle factor.
The kid still flips out because they still see a needle, telling them it isn't going into their skin doesn't make a difference. It actually hurts more because you aren't rotating the site. The medication is what hurts, not the needle. Now all your medication for a week is going into the same spot and it is just getting more and more tender.
If they are colonized like most PICU patients they tend to get staph infections at the sites.