TPN via UVC

Specialties NICU

Published

Specializes in neonatal, pediatric and hospice.

Hi, everyone! Our hospital here in the United Arab Emirates is going through some political and clinical changes so everyone is expected to bring their own contribution towards meeting international standards of care. My question is how you guys are setting up the UVC lines. Our current practice is: D10/TPN bag, giving set, the "traffic lights" (discofix= the in-line taps for drips like dopamine/morfine and so), FILTER (we don't have any of the special filter-needles), 3-way-tap(which we use for intralipids or blood only), and UVC (or plain IV cannula when the doc decides baby is not so sick...)

But when we have a stable baby and the IV Fluids are going into a periferal vein, we find ourself not consistent: the filter goes often before the 3-way-tap...which brings the risk of tiny glass and rubber particles into the blood stream. Some people argue that no matter how we change the policy we will always have double standards regarding this issue unless we start using filter-needles. In heplocked cannulas we don't attach a filter to the T-piece...so here we are! We need to do smth about it.

I hope some of you can help us bring light to this issue :wink2:

and plz excuse my English! I am Romanian :sofahider

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I hope I am reading your question right. We filter all our HAL, no matter what type of line we are using.And we use a tri fuse connector rather than a T connector. We only use T connectors for a perpherial line with say D10 and meds, when there is no lipids.

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Specializes in NICU, PICU, educator.

Bag, line, filter, connectors, to IV hub. Is that what you are asking? We filter almost everything with the exception of a few drips. IL are piggybacked at the first port below the filter.

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Specializes in neonatal, pediatric and hospice.

Thank you two for the replys. I thaught everything has to be filtered. What drips you don't filter? And smth else: Do you ever run TPN or D12.5 thru UAC???

Thank you very much, once again!

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TPN is the only thing we filter.Everything else comes pre filtered. (Blood, ect)

I may have heard of D12.5 run through a UA. I have run D10 for hypoglycemic kiddos. Hepranized of course.

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Specializes in Neonatal ICU (Cardiothoracic).

I'm slightly confused about your question, but I think this answer is what you are asking for.

We have in-line filters for all our continuous fluids, Dop/Dobut, TPN, UAC fluids [heparin] A-line fluids, but Lipids and some other meds like AmphoB are not filtered. We filter blood products when we draw them up. All our syringe pump tubing has a filter. Everything is attached to a triple pigtail an the UVC/PIV hub. Sometimes we attach another triple to the triple if we need the extra lines for compatible fluids.

I've never given anything but hep/saline through a uac, but others may have a different story.

Stevern21

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We use in-line filters for absolutely EVERYTHING. We put our filters always directly after the fluid. We also use T connectors with everything unless the baby has several gtts and then we usually use however many stopcocks it takes to Y them in. Also, regarding the UAC question, we never run anything other than 1/2 NS with 2:1 heparin through them unless it's an emergency. Our protocol is that the only thing that can NEVER be run through a UA is pressors. Once after taking a kiddo off ECMO, the only access I had was a UA because they were in the process of starting the central line, I gave sedation, antis, and boluses through my UA. Made me extremely nervous.

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Specializes in NICU, PICU, educator.

Indocin and Vasopressors and NAHCO3 are our big no-no's for our UAC's. I have given TPN thru it, antibiotics and sedation if that was the only line I had. Blood too in a bind. I don't like it and we have to have specific orders for it.

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Does anyone ever give Intralipids through a UAC? Do you have a reference for why you do/ or why you do not??

Thanks.

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Specializes in neonatal ICU, adult med/surg.

If we have a UAC and a UVC then the TPN and lipids run through the UVC and 1/2NS with heparin 1:1 runs through our UAC; otherwise our TPN and lipids run through our UAC. We never run pressors, bicarb, or blood through our UAC's

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