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Discussion

IV contamination?

I'm a nursing student and went to get a vitamin IV drip at a medspa. I was watching the nurse after she set up my IV and was setting up the next patient. She spiked the bag and primed the tubing and when she went to hang the port end (which still had the cap on from the sterile package she opened) onto the pole, it fell on the floor and she just immediately picked it up and hung it back on the pole. She used that same tubing to connect to the patient's IV. Should she have changed the tubing since part of it fell on the floor or is it not considered contaminated since it was still capped? I'm mainly just worried for the patient. Are the chances they will develop infection from that high, or will they be OK? 

 

 

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    Couple different ways to answer this. Professionally it would have been best to discard the tubing as the cap is not a super impermeable barrier, the caps are primarily designed as a sharps hazard control. There are also other concerns such as bioload on the tubing, cross contamination, etc. 

    Realistic answer is that the risk to the patient would have been exceedingly low with infection being the most serious hazard. Rates of infections with peripheral IVs is generally low in general with something like 0.2/1000device days being commonly cited. With short term PIVs it is possibly much lower. 

    Then again...should the patient get an infection (CABSI/PLABSI) the mortality rate is exceedingly high with rates being around 25% or so. That means these infections are much, much worse than getting breast cancer or HIV. I read a publication where a surgeon reported that patients with GSWs to the chest, should they make it to the hospital alive, had about a 10% mortality rate. That means you would rather get cancer, rather contract HIV, or rather someone shoot you in the chest in the hospital than get a CABSI/PLABSI. 

    Risk is very low but consequences are very high however. 

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