When changing the IV bag, should the connection between the IV tubing spike and the bag be cleaned with alcohol?
No! The covered spike end and the male luer end are the only parts that are covered by caps when you take it out of the package. That means those are the only sterile parts, in addition to the internal fluid pathway. Those external sterile parts must remain protected. It should never be allowed to touch anything other than the channel of the plastic bag opening or the rubber stopper of the bottle. If it does accidentally touch some other surface, it must be changed completely. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Office Phone 770-358-7861
I agree with Lynn 100%... Valorie
Valorie Dunn,BSN, RN, CRNI, PLNC
So even when just changing the bag and continuing to use the tubing (tubing used for 72 hours, bag changed every 24 hours) you would not clean the area between the spike and bag before removing the old bag.
Ann Podruchny MN, CCNS, RNC-NIC
Definitely not!! You would hang the new bag, remove the covering from the channel for the spike, remove the old bag from the pole, carefully withdraw the spike from the empty bag and discard bag, do not allow the spike to touch anything. While holding the channel on the new bag, carefully push the spike straight into the channel on the new bag. Any attempt at cleaning will only result in contamination of the sterile spike. If this spike touches anything or if you drive the spike through the side of the plastic channel (this is common), then the whole set must be changed. There has never been any guidelines, standards, studies or publications of any kind that have even mildly suggested that there should be any attempt at cleaning this spike. Studies have even shown that the set could be used for 7 days but the new CDC guidelines is going to say change the set no more frequently than 96 hours. The risk of contamination is not coming from the spike end nor the fluid container. The risk is coming from the male luer end that is disconnected and reconnected for intermittent use. So when continuous fluids are prescribed, the set should never (and I do mean never, not ever for any reason) be disconnected from the catheter until it is time to change the set completely. When not in use, those sets used intermittently must have the male luer end protected with a new sterile end cap. Do not use the tip from a syringe. Do not use a foil packet from an alcohol swab. Do not connect the end to an injection site on the same set. And do not make any effort to clean the spike or surrounding area. Lynn