Sterile nacl or h2o???

[Lasoniamacaroni]

hi. I was trained that we give sterile water for cancer cases (breast, etc...) Something about being hypotonic and its effect on lingering cells. I tried giving water at my new job and they thought I was crazy. Wouldn't take it...and started to question myself. LOL. So, is this some old school hairbrained idea that was beat into my head for years for no reason? What solution do you give?

[goats'r'us, ASN, RN]

i've heard this one too, and there are a few surgeons who go with it, but most use saline.

i got similar crazy looks when i started at a new hospital and found that they use saline in neurosurgery. i was taught at my previous hospital that ringers solution is the closest thing to CSF so should always be used in neuro, but my new hospital didn't even stock it!

[Natalie - new OR RN]

This concept was presented to me today with the same rational, (that sterile H2O may be used in oncology cases b/c it kills cancer cells due to the hypotonicity, which makes sense to me), but I'm a little confused on WHEN to actually use it. We were doing a cytoreduction for a pt w/ovarian cancer that had metastasized. I was also told, (during the same case), that you'd never want to use sterile water for peritoneal washings, (which was a part of our procedure), and that that should always be done with saline. Are there any experienced OR nurses out there who are familiar with this concept that can give me more specific information on when using water would and wouldn't be appropriate in a cancer case??? Thanks in advance...I am a newly graduated nurse starting out in the OR & am trying hard to make sense of all the new things I am learning!

PS. I'm pretty sure that we use sterile water for cystoscopies, (which makes sense to me since it's not entering the bloodstream in that case), but the posted article about the nurse using water then diet coke to unclog a catheter makes me second guess that. Of course I understand why using diet coke & poor technique is shocking & crazy, (how did she not lose her license???), but was her decision to use sterile water in the absence of NS really that egregious?

[RNOTODAY, BSN, RN]

yes, we use water for irrigation in cancer patients........at a large teaching medical center

[DLuxe]

We use water for lumpectomies and other small cancer surgeries although there usually isn't a whole lot of irrigating actually going on.

[canesdukegirl, BSN, RN]

Some of our onc surgeons insist on having only water to irrigate during breast ca cases, and some claim that NaCl irrigation has no effect on the cells.

MOST of our surgeons use sterile water to irrigate for BRCA cases.