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IV Drips and normal saline back ups

I have been set on the task of figuring out if all IV drips need a Normal Saline backup.  Currently, where I work, it is our practice, but I have not been able to find any evidence based research to support this practice.  I know blood needs and PCAs need backups, but what about insulin drips, or dilaudid, etc.  Any input would be greatly appreciated.

I can not think of one single

I can not think of one single valid reason to have a "backup" fluid for any large volume infusion. Most facilities now infuse everything on a pump. This means that the rate and volume to be infused is set and an alarm is sounded before the bag completely empties. The nurse must go to the bedside and change the fluid container to add a new one to the set. This backup fluid would only add cost and signficant risk for many patients who would not be able to handle the additional fluid.

I do know that some facilities use backup fluids for small volume infusions (e.g. 50 to 100 mL infusing for 30 to 60 minutes). A busy nurse may not have time to return precisely at the time when the fluid has infused to disconnect and flush the catheter. This carrier or backup fluid will prevent blood reflux and clotting until the nurse can actually return to the patient. There are 2 products that will do the exact same thing without the additional fluid - PASV catheters from Navilyst and the TKO Connector from Nexus Medical. Both products function by an internal pressure-sensitive valve. When the fluid has completely infused, the valve automatically closes preventing blood reflux.

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

Robbin George
  ICU Medical Receives FDA


ICU Medical Receives FDA Clearance for its Neutral-Pressure Needleless Connector

ICU Medical, Inc., a manufacturer of disposable medical connection systems for use in vascular therapy applications, today confirmed that it has received FDA 510-k clearance for the Neutron™ Neutral-Pressure Needleless Connector. The new connector incorporates patented technology from ICU Medical that is designed to prevent all types of blood reflux in a catheter, including line or syringe disconnection, patient vascular pressure changes caused by coughing or sneezing, as well as an IV bag running dry—all of which are associated with catheter patency.

As a neutral-pressure device, the use of the Neutron may help hospitals address Food and Drug Administration (FDA) concerns about the safety of positive-displacement needleless connectors and their possible connection to higher rates of device-associated bloodstream infections (BSI). Following three reports of deaths associated with BSI and positive displacement needleless connectors—and increased concerns raised by infection control authorities including the Society for Healthcare Epidemiologists of America and Infectious Disease Society of America—the FDA last week ordered manufacturers of positive displacement connectors to conduct a post-market surveillance study on the safety of these devices.1

In addition to the device's neutral-pressure features, the Neutron also incorporates a pre-slit septum that was recently noted in the 2010 Draft CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections as being a preferred design feature to aid in the prevention of bloodstream Infections.2

ICU Medical, Inc. expects to conduct expanded clinical beta testing of the Neutron with select customers in the third quarter of 2010.


1. FDA Medical Device Safety Alert, July 28, 2010: Letter to Infection Control Practitioners Regarding Positive Displacement Needleless Connectors (

2. Guideline for the Prevention of Intravascular Catheter-Related Bloodstream Infections, Final Issue Review, May 17, 2010 (

Robbin George RN VA-BC

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