Re: changing protocol for add on valves ie) ultrasite valves

[Lynn Hadaway]

Title: Re: changing protocol for add on valves ie) ultrasite valv

That is what I am saying - hub to hub connection when a continuous infusion is going.

That needleless injection system is luer locked to the catheter hub just like the infusion tubing. It can become disconnected equally as well. There is no evidence that this is a safer method of connection. Plus it adds another connection which increases cost and there are now 2 connections instead of 1.

For the home cyclic TPN patients taught to change everything every day, I don't understand how this provides any protection. Some may argue that disconnection from the needleless device only means that the patient does not have to open the line and risk air embolism. This is true but if the needleless device is changed with the tubing everyday the catheter must be opened anyway. So how does this provide any additional safety? Lynn

At 6:04 PM -0700 9/20/06, Penelope Scott wrote:

Lynn, to clarify, are you saying you would not use a cap of any kind with a continuous infusion, just hub-to-hub ?

We (in-hospital and for home) use a split septum or a luer accepting cap for all infusions, safety in case of disconnects is a big part of the rationale. Almost all of our home TPN patients are on cycled 3 in 1 infusions, and we have them change everything including the cap daily (and scrub the hub).

They are taught to never interrupt the infusion.

Penny

On Sep 20, 2006, at 5:14 PM, Lynn Hadaway wrote:

First, I would ask why you are using a needleless injection system for a continuous infusion? I have never seen the need for this.

The CDC guidelines state that these injection systems need to be changed at the same time that the tubing is changed. When lipids are infusing, this means changing every 24 hours. Without lipids, you can change tubing and injection system every 72 hours.

If it has to be changed at the same time, and it adds another connection plus cost, I can not see the need for its use with any continuous fluid. The only possible reason I have heard would be to make it easier for disconnection while the patient takes a shower. But should IV fluids such as TPN or any other medication be stopped for that period?

Lynn

At 3:44 PM -0700 9/20/06, sandy damico wrote:

Sandy

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Lynn Hadaway, M.Ed., RNC, CRNI

 Lynn Hadaway Associates, Inc.

 126 Main Street, PO Box 10

 Milner, GA 30257

 http://www.hadawayassociates.com

 office 770-358-7861

--

Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861