We've searched both INS and ONS and there seems to be no recommendation regarding running chemo as a primary or as a secondary. Our new cancer center has always run it as a primary, but their patients are outpatients and do not usually have an existing IV infusing. The hospital chemo unit has always run it as a secondary. We want to have one standard practice. What are your facilities doing?
thanks for any help. Peggy
Forum topic
Wed, 04/06/2016 - 22:14
#1
phampton
Chemotherapy run using primary tubing or as secondary?
There is no actual standard stating that one method is better than the other. There is now a new document that applies to hazardous drugs - USP <800>. It just came out and I have not read the final version completely yet but it might have some new information about this. The big news from this new USP chapter is their strong statements about using a closed system drug transfer device to prevent spraying or leaking of these hazardous drugs into contact with you and the environment. I would prefer to give all hazardous drugs as a secondary piggybacked into plain fluids. 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
thank you for your responses. Peggy
Peggy Hampton, RN
Clinical Education Specialist
Yuma Regional Medical Center
We are using both methods. Secondary for most infusions: and primary (or dedicated line) for chemo drugs that required low sorbing tubing or other requirement. Both systems are fine. The closed system also available in both primary and secondary set.
Diana
I prefer secondary as a standard for pharmacy and primary if a special non-PVC tubing is required because of the drug, e.g. etoposide. A secondary allows you to use the primary for two things: 1. flush more drug into the patient by using the priming fluid for clearing the line 2. Back prime the connection of the secondary to the primary line. This provides for less drug at this connection if the nurse is disconnecting the secondary to hang the next chemo. Safer for nurses, even with PPE on.