I would like to ask what is everyone doing when reconstituting IV medications. Are facilities still using a 5 micron filter needle to draw up reconstituted medications or are they using filter needles only when drawing up from a glass ampule? I was always taught to use a filter needle for both instances prior to administering the IV medication. Filter needle use seems obvious to prevent glass shards from being administered, and a 5 micron filter needle will capture 98% of other particulates. It seems it would only be prudent to always use when you are reconstituting medications from a vial. Any thoughts?
Kelly R
This is addressed in the INS Standards, #28 Filters, A blunted filter needle or filter straw shall be used when drawing medications from glass ampoules. As you stated the problem is the glass shards. For a rubber stoppered vial, there can also be a rubber core but that is visible, unlike the tiny glass shards. I am not sure about your statement regarding a 5 micron filter removing 98% of other particules. Do you have a reference for tht? Numerous particles such as organisms are smaller than 5 microns in size. My vote would be to use a filter for everything, and I do believe the evidence is heading in that directions. We just don't have enough evidence to change practices yet. I strongly agree that filters are required for anything from a glass ampule. Lynn
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
The manufacturer BD gives the statement that the 5 micron filter removes 98% of particulates. I have felt that anything that if physically mixed from a powder form has a great potential to have particulates that can cause issues. Typically anything admixed in pharmacy are filtered as they are drawn up so I am confused why my facility does not seem to think this is an issue at the bedside. i totally agree with you that we should use a filter for everything. Thanks for the info.
Kelly R
To answer your question, no our hospital does not use filtered needles when drawing up reconstituted IV medications through a rubber stopper.
Today I learned that Genentech will be recommending use of a 5 micron filtered needle when drawing up reconstituted Cathflo for doses sent out after March 23 (or 25?). Evidently the recommedation for the use of a filtered needle is related to the reason for the Cathflo shortage.
http://prod.cathflo.gene.s3.amazonaws.com/pdf/Cathflo_DHPC_3_22_13.pdf
Nancy
Nancy Rose