Saline flushes causing nausea for my patients

Specialties Oncology

Published

Just looking for some advice. I am the Oncology Resource Nurse and have had multiple patient c/o nausea following saline flushes. The flushes we use are preservative and latex free. My nurses have now resorted to drawing up their own flushes from a bag of saline which we know is a no-no but we are stuck. Have any of you experienced this? If so what was the solution? Thanks for your advice

I work in an outpatient treatment center with mainly oncology patients, and we hear this a lot. But we've actually found a solution: for these patients, we don't use the pre-filled syringes but draw the saline up from individual 10-ml vials. I know that if you read the label on the vial and the label on the pre-filled syringe it looks like they should both be exactly the same thing in terms of preservatives, etc. that could cause the nausea, but we've concluded that there's some kind of difference because this solves the problem for these patients. This has baffled all our RNs, doctors, and pharmacists, but this solution has worked for us.

amy

Specializes in Vascular Access.
I work in an outpatient treatment center with mainly oncology patients, and we hear this a lot. But we've actually found a solution: for these patients, we don't use the pre-filled syringes but draw the saline up from individual 10-ml vials. I know that if you read the label on the vial and the label on the pre-filled syringe it looks like they should both be exactly the same thing in terms of preservatives, etc. that could cause the nausea, but we've concluded that there's some kind of difference because this solves the problem for these patients. This has baffled all our RNs, doctors, and pharmacists, but this solution has worked for us.

amy

But a 10 cc Normal Saline vial has zero preservatives in it! Neither do most prefilled syringes as both contain single dose saline. The difference between them may be the manufacturer, but both contain 0.9% sodium chloride.

Hello, I'm not a nurse or medical professional, but signed up for the the ability to address this from the other side of the needle, so to speak.

I am going through chemotherapy to treat breast cancer. I am someone who developed a sensitivity to the IV saline mid-way through the AC portion of my chemo. I've always been able to taste it, but it never bothered me until the day it did. With no warning, the IV flush made me violently ill. Every time it's done, I immediately begin to vomit. I assumed it was psychosomatic or anticipatory until my last treatment. I'm in my 10th of 12 taxol infusions. My Goddess of a nurse noted that I was severely dehydrated and asked if I'd like a saline drip along with infusion. Since she's laughably aware of my saline "issue", she assured me that it was going directly through my port line & wouldn't taste it etc. She was correct in that, however, minutes into the procedure (which included sedation), I began to vomit uncontrollably; which leads me to consider that it's more than an anxiety response.

From my experience as a patient, I'd like to confirm what some of you have recommended. A slower push is tremendously effective! As is sucking on a hard candy with a strong flavor (I go with green lifesavers ;) ). I also plug my nose and breathe through my mouth. I am deeply grateful to my oncology nurse and her willingness to try alternate methods. I hope this helps.

Thank you!

I work in an outpatient treatment center with mainly oncology patients, and we hear this a lot. But we've actually found a solution: for these patients, we don't use the pre-filled syringes but draw the saline up from individual 10-ml vials. I know that if you read the label on the vial and the label on the pre-filled syringe it looks like they should both be exactly the same thing in terms of preservatives, etc. that could cause the nausea, but we've concluded that there's some kind of difference because this solves the problem for these patients. This has baffled all our RNs, doctors, and pharmacists, but this solution has worked for us.

amy

Hi. I am an RN in australia. My hospital does not use prefilled syringes of normal saline (i have actually never seen them) and i have never heard of any patient becoming nauseous or have salty taste with normal flushes - so i agree with you it must be the syringes. I wonder if it is something the prefilled syringes themselves are made out of and it is leaching into the saline while it sits in the syringes?

Specializes in Peds Heme/Onc.

I realize this is a super old post, but maybe someone can still use this... I've found that with some of our kiddos that flushing with D5 instead of NS eliminates the nausea issue. Just make sure your med is compatible, and have your pharmacy draw up some syringes for you.

1 Votes
On 2/1/2010 at 8:22 PM, heron said:

Not an oncology nurse, here, but I wonder if they could also be having a conditioned response ... isn't some chemo given ivp? I've heard that some pts actually get nauseated before they even get their chemo, just with the anticipation.

I was hospitalized over the summer with pneumonia and let me tell you, I could taste the saline when they used the flushes. It was weird and not something I experienced before.

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