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Mon, 07/02/2007 - 11:48

Patty Luptak

3% Na Chloride

Does anyone have any good articles or literature I can use to support my cause to continue infusing 3% Na Chloride through Central Lines rather than peripheral sites? One renal physician insists we give it peripherally and wants to take it to P&T. I need some good reference other than the osmolarity which I have already cited to her

Thanks

Patty Luptak, RN OCN

Director Oncology/Infusion Services

Jefferson Regional Medical Center, Pittsburgh, PA

Fax 412-469-7338

Mon, 07/09/2007 - 10:23

lynncrni

Osmalarity and the

Osmalarity and the inevitable vein damage are the only reasons that I know of - osmolarity is 1026! Phlebitis, tissue destruction upon extravasation etc are great possibilities. But on the other hand, this fluid should be limited by time or volume, so there may be valid reasons for not placing a CVC for only a few hours of infusion. Risk vs benefit assessment is required. If peripheral veins must be used, your policy should be to use the smallest catheter in the largest vein with adequate catheter stabilization and avoid all sites near joint flexion. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Mon, 07/09/2007 - 13:43

Patty Luptak

I was able to find one

I was able to find one reference from the University of Pennsylvania that the patient must have a central line before 3% NACL is infused or they do not meet the criteria for infusion of that solution. I guess they are not taking any chances with damaging veins period. There were other criteria but that was one of them and if even one of the criteria was not met, the infusion did not happen.

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