IV Fluid contamination

RE: IV Fluid contamination

Michael Woodhouse — Fri, 04 Jan 2019 11:42:38 GMT

[quote user="Thomas Johnson"]I suspect that a lot of the occasions when people use sterile saline, such as flushing wounds or ears, they would do just as well to use tap water.[/quote]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472650/

I'm told it's all the NHS uses for wound irrigation these days.

I might use a bag up to save wasting it, but I wouldn't open (and charge) a bag when we know tap water is equally as good and basically free

RE: IV Fluid contamination

Clive Ansell — Fri, 04 Jan 2019 10:55:21 GMT

[quote user="Thomas Johnson"]I suspect that a lot of the occasions when people use sterile saline, such as flushing wounds or ears, they would do just as well to use tap water.[/quote]

For sure, but why would you when sterile saline is cheap as chips and readily available?

I'm happy to use already opened bags for wound and ear flushing etc.

RE: IV Fluid contamination

Thomas Johnson — Fri, 04 Jan 2019 08:21:41 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Neil Wheadon"]If a bag of fluid is produced, transported and 10ml used from 250ml then maybe it's useful to know how to use the other 240ml.[/quote]

Maybe it would be better not to open a 250ml bag at all if you're only going to use 10ml.

[/quote]

I suspect that a lot of the occasions when people use sterile saline, such as flushing wounds or ears, they would do just as well to use tap water.

RE: IV Fluid contamination

Evelyn Barbour-Hill — Thu, 03 Jan 2019 19:35:48 GMT

[quote user="Neil Wheadon"] If as it seems there is negligible contamination after 48 hours, I have no issue in using the rest.[/quote]

Nor me. Just not for intravenous infusion.

[quote user="Neil Wheadon"]

[quote user="Clive Ansell"]I wonder what a client would think, and what would be potential consequences of an infection or complication arising through using contaminated fluids?[/quote]

and if shown to be zero as this paper suggests?

[/quote]

The paper was concerned only with contamination of the bag of fluid, and only with such contamination as might be caused by puncture of the addition port with a sterile needle. And it didn't really demonstrate anything about number of days to contamination.; what it demonstrated was that it took between 6 and 12 needle punctures of the addition port to produce contamination that could be detected by culture. Interesting, but of little relevance as to whether it is safe to re-use the bag for repeated intravenous infusions.

People reusing the bag for one intravenous infusion after another after another will be using the same giving set as well. I'll lay the Luer end of that is contaminated by the time it gets into the second patient's cannula, and if it isn't it will be by the time it gets into the third patient.

[quote user="Neil Wheadon"]If a bag of fluid is produced, transported and 10ml used from 250ml then maybe it's useful to know how to use the other 240ml.[/quote]

Maybe it would be better not to open a 250ml bag at all if you're only going to use 10ml.

RE: IV Fluid contamination

Neil Wheadon — Thu, 03 Jan 2019 16:17:02 GMT

[quote user="Clive Ansell"]Relatively inexpensive consumables, can even acquire 250ml and 100ml bags, so use new and just invoice it to the client.[/quote]

Looking at your average veterinary bin is pretty shocking. Plastic ends to needles, syringes, lots and lots of consumables. If a bag of fluid is produced, transported and 10ml used from 250ml then maybe it's useful to know how to use the other 240ml. If as it seems there is negligible contamination after 48 hours, I have no issue in using the rest.

[quote user="Clive Ansell"]I wonder what a client would think, and what would be potential consequences of an infection or complication arising through using contaminated fluids?[/quote]

and if shown to be zero as this paper suggests?

Neil

RE: IV Fluid contamination

Clive Ansell — Wed, 02 Jan 2019 13:41:09 GMT

[quote user="Evelyn Barbour-Hill"]FFS why not just throw the bag away [/quote]

I was thinking the same thing.

Relatively inexpensive consumables, can even acquire 250ml and 100ml bags, so use new and just invoice it to the client.

I wonder what a client would think, and what would be potential consequences of an infection or complication arising through using contaminated fluids?

I have seen practices that peddle IVFT as part of a so called gold standard GA package, then just use an already opened bag and giving set peri op whilst still charging the client top dollar.

RE: IV Fluid contamination

Bob Russell — Wed, 02 Jan 2019 12:56:10 GMT

I would never use an opened bag for i/v use even the following day. Might use it to flush a contaminated wound but really not worth the effort. Just cut the bag, empty down the sink and bin.

(we generally keep the bag to use as temporary protection for foot dressings so the owner usually bins the bags!)

RE: IV Fluid contamination

Evelyn Barbour-Hill — Mon, 31 Dec 2018 19:53:17 GMT

FFS why not just throw the bag away (or keep it in the fridge a few days and use it when you want saline that doesn't have to be sterile).

Oh, money-saving tip, empty the bag down the sink and just put the empty bag in the appropriate waste container.

RE: IV Fluid contamination

Neil Wheadon — Mon, 31 Dec 2018 15:26:25 GMT

[quote user="robloxley"]I do therefore wonder what the results would be if the port was disinfected?[/quote]

Funnily enough it goes on to say

Swabbing access ports with a saline-soaked cotton swab mechanically removes greater than 99% of microorganisms; using 70% ethanol increases microbe eradication

ref

1. Salzman MB, Isenberg HD, Rubin LG. Use of disinfectants to reduce microbial contamination of hubs of vascular catheters. J Clin Microbiol. 1993;31(3):475-479
Neil

RE: IV Fluid contamination

Rob Loxley — Mon, 31 Dec 2018 13:54:26 GMT

[quote user="Neil Wheadon"]the study design purposefully called for not disinfecting the injection port[/quote]

I do therefore wonder what the results would be if the port was disinfected?