Dear Elizabeth,

The following link may be helpful:

http://www.icid.salisbury.nhs.uk/ClinicalManagement/IntensiveCare/Pages/ArterialLineManagement.aspx

Rafik

Rafik,

  I have tried the link and this is what comes up  :Unable to connect to database.  Check database connection information and make sure the database server is running. Any other way to access the information?

Thank you so much,

Lisa

Rafik,

  I was able to source the information by going through each heading.  When getting to the specific practice and rationale this is what is given:

16. Label the system when set up with date and time

Rationale: To ensure it is changed as per protocol

17. Label the arterial line

Rationale:To prevent accidental drug administration

This does not given a time frame from time it is put together and when it is attached to the patient.  The only time limit that is given is:

6. Preventing Infection

Handwashing and the use of Personal Protective Equipment (PPE)

Every third day (72 hours) the transducer and flush bag should be either changed or taken down if no longer required

The flush bag should be changed with the transducer or when empty

Maintain a closed system ensuring minimal disconnection in the circuit

My understanding that this 72 hour time frame is based on patient use, not before hand.  It only mentions date and time to be changed base on protocol not necessarily data.

What do you think,

Lisa

Dear Elizabeth,

You are absolutely right. I have searched for data but I have not succeeded to find any reference.

Rafik

Rafik,

  Thank you for the response.  I've most recently found information within my organization that says, "Plain IV fluids in central lines and all other IV's are good for 24 hours after the bag has been spiked, as long as it is not past the NaCl bag's beyond use date." I've found my project, I think!

Thanks for your input!

Lisa

Dear All:

Please take in consideration the 2011 Guidelines for the Prevention of Intravascular Catheter-Related Infections (https://www.cdc.gov/hicpac/BSI/BSI-guidelines-2011.html), and in the page 18, the guidance will be 96h.

Best regards

M. Valente

請問大家:

       一定要用 0.9% NaCl 嗎?

可以用 0.45% NaCl 嗎?

Mr. Valente,

  The CDC Guidelines you are quoting...

 9. Replace disposable or reusable transducers at 96-hour intervals. Replace other components of the system (including the tubing, continuous-flush device, and flush solution) at the time the transducer is replaced [37, 161]. Category IB

This makes the assumption that it has already been connected to the patient based on the term, "intervals".  The time frame I am looking for only happens once and it is before all of the components (listed above) are combined together (to create the A-line "set up") to the time of use during patient care.

Thanks for the input,

Lisa M.

Dear Elizabeth:

The racionality of the context, is that if you manipulate the components of the system in a clinical context, you introduce a grade of risk of contamination, not present when you start the process; considering that, in my opinion the interval to take in account to manage the continuous flush devices was 96h, starting from the first moment you set up the system. Also you have to take in account that all the invasive medical devices should be exposed to the environment the least time possible after its opening from a state of sterility.

Best regards

M. Valente

Mr. Valente,

  You make very good points on the system components and the risk of contamination based on manipulating them. The problem lies in having data to back up your opinion that the interval of time should be 96 hours. Currently, there is no data or research that has been conducted to prove that is a feasible time frame prior to patient use.

  Personally, in working in the Operating Room, we use Arterial Lines often, between 1 to 8 hours at night and approximately 5 to 6 A-lines during the average day of a 12 Operating Room, Surgical Services Department. So, the 96 hour interval would not be a practical time frame within our context of patient care. Time frames prior to use is the question at hand and currently no data has been identified to quantify the variable of time.

Thank you,

Lisa McInnes