"Expired" warmed solutions for Turp,turbt

[brewerpaul]

We use warmed glycine or saline for turp or turbt procedures (depending on the equipment used). Our OR has a policy of leaving the bags of solutions in the warmer for no longer than 14 days. When they're put in to warm, we mark the outer bags with an "expiration" date.

Although nobody really sure why, it seems that this policy is to prevent the warmth from leaching potentially harmful chemicals from the plastic bag into the warm solution. NaCl won't be chemically changed by body heat warmth, but I'm not sure about glycine.

Question coming up...

When we take out solutions that have been in the warmer longer than 14 days, some people put them back in the bins to be used for other cases unwarmed. Do other nurses here do that? Personally, I don't want ANYTHING in my OR with an EXPIRATION date less than the date of the procedure. I'm not sure if there is any real danger, but in the case of a malpractice suit, a prosecuting attorney could make a lot of trouble with that.

Other people simply take off the outer bag which was marked with the expiration date.

Does anyone know of any research or evidence on this topic? Thanks.

[Rose_Queen, BSN, MSN, RN]

We do the same thing, although I've never seen the research. Our expired fluids go down the drain, no exceptions. Here's a few tips you might want to suggest to keep from having to get rid of fluids:

-Make sure the person responsible for stocking is rotating the bags. We have one PCA I keep having to talk to about just shoving the new bags/bottles in front of the old ones. (A) They aren't warm when you go to grab them and (B) then there's a whole bunch in the back that end up down the drain.

-Take a few weeks and average out how many bags you're using per day. Then pick a slightly higher number as the daily par level, rather than just completely fill the warmer. (Not a problem for us, we have to refill halfway through first shift!)

or

-Look at the schedule for the next day, and use that to base how many bags go in the warmer overnight.

[morte, LPN, LVN]

If that is the reason (leaching of chemicals) the maker should be able to give you that infol. I was told years ago, by a Baxter rep, that IV solutions were only good for a month, when the outer cover had been removed.