Here at Children's of Minnesota we are looking at luer locks and luer slips on our connectors going into I.V. catheter hubs. There is some hesitancy to use luer lock connections, particularly in smaller babies. Would you answer the following:
1. Does your institution use luer lock, luer slip or a combination with tubing that connects into an I.V. hub?
2. If you use luer lock connections, have you had issues with skin integrity (e.g. pressure ulcers/injuries) or any other problems.
We primarily use slip end T-connectors on our peripheral IVs. We do use luer lock on patients requiring CT with power injection and in other cases. I have indeed seen skin breakdown from the pressure of the luer lock but I have also see it with luer slip, although less often. Sometimes a small piece of gauze can be placed under the connection to reduce pressure. Tape too tightly applied can increase the potential for skin injury as well. Obviously luer lock connections are used on all our CVADs.
The national standard of practice is to use luer lock connections on all connections for all patients - See INS standards. I can appreciate your concern about skin integrity but this can also happen from the catheter hub alone. In my opinion, all PIVs require this padding under the hub and tubing connection rather than being taped tightly directly to the skin. There is a concern about the size of the luer lock on small babies, however the risk of a slip lock coming apart is far too great. Air in CT scans of the brains of infants has been documented when the infant only had a PIV and nothing else. Leaking, bleeding, contamination - all serious problems that could encourage the loss of a PIV in an infant. Lots to think about but patient safety says use a luer lock! Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861