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Prefilled Saline Syringes
Our hospital just obtained 10ml prefilled saline syringes any suggestions r/t protocols for use?  We are a very small hospital, use will not be large.  Any concerns r/t use with routine peripheral site flushing?
Nadine Nakazawa
Nadine Nakazawa's picture
Many clinicians do not
Many clinicians do not realize that these prefilled syringes have a sterile fluid path, but they are NOT sterile on the outside.  In other words, they cannot be placed on a sterile field, eg, central line insertion or port accessing.

Also, many nurses try to "save money", by flushing with half a syringe, put the syringe down, giving an IV med push, then using the same syringe and flush the remainder of the saline in.   Clinicians need to understand the risk of contamination of the catheter hub with this technique.   They should use each prefilled syringe for one flush, and then toss.

Nadine Nakazawa, RN, BS, VA-BC

My understanding of
My understanding of prefilled syringes is that they are manufactured sterilly, but do not have the required "sterile" packaging, so therefore they cannot be deemed sterile because the packaging can be compromised and sterility cannot be assurred. I wonder if we can get something from the manufacturers with such a statement. We really could use a sterile pre-filled syringe for the procedure.
Nadine Nakazawa
Nadine Nakazawa's picture
There are "sterile field
There are "sterile field prefilled syringes."     Contact the rep for the syringe company you use, and get the pricing and ordering codes.   You will have to go through your purchasing dept and get the OK first.   Then you have to figure out how to educate staff so they don't use a sterile field syringe when a regular prefilled would work.   Sterile field syringes are much more expensive, but make life so much easier when doing a sterile procedure.   We're using them for our PICC insertions---no more breaking glass vials and drawing up saline with a filter needle---so much wastage and time consuming.   Great if you need more saline in a difficult insertion.

Nadine Nakazawa, RN, BS, VA-BC

We use BD pre-filled flushes
We use BD pre-filled flushes for IV's that is sterile saline, but the outside of the syringe is not sterile, therefore not used on PICC insertions. These are great to avoid using multiple dose vials of saline, saves nursing time, too.  We also use BD pre-filled syringes that are sterile on the outside of the syringe, therefore great for use during line insertion, by by physicians & PICC nurses. 

Victoria Sallese, RN, VAT, PICC service

ann zonderman
Ann Zonderman, BSN, JD,

Ann Zonderman, BSN, JD, CRNI, LHRM

 Nurses by nature tend to save/ use later - save money, people, but Reinforce - single use only.... do not save any left over, even for minutes..... Do not use the caps from the syringe on the end of IV tubing.... Products are labele single use only.....

reuse,second use is not ok... if a problem arose and was tracked to such practices, the nurses would be liable.



Ann Zonderman, BSN, JD, CRNI

Halle Utter
Does anyone know if any of
Does anyone know if any of the manufacturer's are planning on putting the sterile prefilled syringes in the PICC insertion kits?  This would be such an improvement over the glass vial and filter needle, plus a huge time saver.  Also, has anyone run into problems with PICC tray storage due to the fact they have meds inside?  I have heard some nurses say due to JCAHO requirements that the PICC trays have to be stored in the med room under lock and key.  Another facility RN told me that the kits wouldn't be coming with any saline or lidocaine inside due to this JCAHO reg?  That would mean you would have to add the lidocaine and saline separately and check it out each insertion on each patient - another huge time concern plus sterile field issues.  Anyone dealt with these concerns yet or heard anything?  Thanks in advance.

Hallene E Utter, RN, BSN Intravenous Care, INC

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