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Disconnected IV Tubing

Hello. I work in a pediatric hospital and there have been a few times lately in which chemotherapy or a drug like ATG disconnects.

Chemotherapy: Since the end of the chemo tubing has a closed system device on the end (spinning Spiros) (that is fixed once applied to the tubing and can't be removed), if it disconnects it prevents a chemo spill. However, now what to do with a contaminated tip? Should we waste the chemo in the tubing and have pharmacy re-spike the bag with new tubing? Or should we really scrub the end of the Spiros with alcohol and re-connect? Same scenario for some expensive SCT drugs such as cyclosporine or tacro or Anti-Thymocyte Globulin.

I have always told RNs that if it is maintenance IVF or Hyperal/TPN to re-spike the bag onto new tubing as there is always overfill but not sure what to do with the above scenarios.

I also say part of the hourly IV check should not only include the site but also the connections, the pump and IV bag or syringe.

 CDC and INS state to access

 CDC and INS state to access all VADs ONLY with a sterile device. Once contaminated there is no way to scrub enough to render the surface sterile. So you must remove the contaminated set and spike a new one. The obvious thing to do is to prevent this from happening in the first place. Is the Spiros connected to another needleless connector on the catheter hub? If so, this could be the problem. Some NCs have a short luer lock without many threads. This prevents attached devices from gaining a well seated connection, even though the nurses have tried to luer lock it together. It sounds like this is a significant problem for you. I would contact manufacturers of all products and see what can be done to resolve this issue. 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

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