In our IV therapy department we pre-fill TB syringes with 0.9% bacteriostatic saline to help numb before our peripheral starts. It has been very effective in reducing patient discomfort and we have not ever seen any adverse effects. We were recently informed that pre-filling these was not an accecptable practice and we would now need to prepare each syringe before going into the patient room. We think that would greatly affect our work flow. Has anyone else dealt with this issue or have any ideas where we could research this? Thank You
This is coming from USP <797>, a mandatory chapter in USP regulations titled Sterile Compounding Preparations. They state that immediate use medications can be prepared outside of a laminar airflow workbench when patient care will be harmed by the delay in getting the meds to the patient and the med is used within 1 hour of the time you begin to prepare it. So drawing up enough for your entire shift is far outside this regulation. There are several studies on nurses preparing syringes that show a rate of 8% contamination. So it may not be frequent but it can and does happen. This contamination can easily lead to SC tissue infection for this local anesthetic and possible a local vein infection as well. Having no known history of problems does not mean that there has not been any problems that went undetected. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
We have been using saline for more than 30 years as a numbing agent. For years we did pre-fill our syringes but stopped that practice probably 20 years ago. It seemed like such a burden at first and we all whined about how it slowed our workflow, but we eventually got over it. Now in hindsight, I can't believe we ever did that and pulling them up individually takes a nanosecond. Before long, you will have that same realization as it becomes your normal routine. Good luck.
Thanks for the help. Its good to know somone else went through the same thing (boy are we behind!)and came out just fine.