Use of large volume NS for Flushes?

Specialties Infusion

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Does anyone have experience using a 500cc bag of normal saline kept at the nurses station or med room with a Braun dispensing pin to draw all flushes(central and peripheral lines)for a 24 hr period? I worry about cross contamination, and what about immunosuppressed patients? Everyones technique different and replacing the cap on the dispensing pin doesnt seem sterile either.Am I making a mountain out of a molehill? I'm sure cost containment of single use vials is the motivating factor as well as reducing use of needles. Thanks for your response.

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Specializes in Med-Surg Nursing.

I have never heard of using a 500cc bag of NSS for drawing up saline flushes! This sounds very unsafe! I read of a case where MRSA or VRE was linked to a multidose vial of 0.9% bacteriostatic sodium chloride! And that was just a 30cc bottle of fluid! At my facility we use 10cc bottles of NaCl for flushes. In case of being out of NaCl to use for flushes I have withdrawn from a 50cc bag on NSS but then have immediately discarded the bag. The practice that you described just sounds like poor nursing care. Just my 0.02.

Kelly:)

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Specializes in Med-Surg Nursing.

Let me clarify what I just said. I used a 50cc bag of NSS to withdraw 25cc of NSS to flush a central line after a blood draw when we were out of the bottles of NaCl. I only used it for one patient.

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At the hospital where I work we use a 250 cc bag of NS for flushes. We use a one way valve adapter (you can't force NS back into the bag) and a three cc syringe to draw up the NS. Each nurse draws what she needs and attaches a new sterile syringe. The bag is labeled for 24 hour change and if there is no syringe on the valve a new bag is hung.. No problems so far .We've had the system for 3-4 years.. TTFN P.S. This is a busy surgical floor with the potential for infections and we haven't seen any increase or changes in our infection rates.... Supposedly, cheaper than prefilled syringes.. Also, you can use any sized syringe with a luer lock mechanism... Also, we have a new pump that can be programed to deliver a saline flush to a feeding tube. It shuts off the feeding and flushes with a pre-set amount of NS at a designated time and then resumes the feeding.. Both bags are changed at the same time.. Usually 0600...

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