In 2014 and 2017, NHS Improvement released patient safety alerts about the dangers of residual anaesthetic drugs in cannulae and intravenous (i.v.) lines seriously harming patients when subsequent fluids or drugs are administered [1,2]. The 2017 action plan specified that 'all cannulae have been identified and either removed or adequately flushed' [2]. No description of how this flushing should be done was included and many anaesthetists believe that an i.v. infusion running through a cannula will achieve this aim.We were concerned that, although a running infusion will clear an i.v. line and cannula lumen, it may have no effect on residual anaesthetic drugs retained in the injection port of a cannula or a three-way tap. In order to assess this possibility, we tested two makes of cannula (Venflon TM Pro Safety (BD, Oxford, UK) 14G and Vasofix â Safety (B-Braun Melsungen AG, Melsungen, Germany, 16G) and a threeway tap (BD Connecta, BD, Oxford, UK).The cannula was connected to a 500-ml bag of saline via an i.v. line, this was used to flush the cannula and then the flow gate on the line was closed. One millilitre of methylene blue was then injected into the injection port of the cannula.The flow gate was then opened to flush the line and cannula until it ran clear, the flow gate was then closed. Five millilitres of saline was then injected into the injection port of the cannula. On doing this, evidence of dye contamination was clearly observed on a white swab placed at the cannula tip ( Fig. 1). Similar results were observed when the procedure was repeated using a different manufacturer's cannula and a three-way tap (Fig. 2).This demonstration shows that a running i.v. infusion line does not adequately remove residual contamination from cannulae or three-way taps. It is therefore essential that anaesthetists flush all injection ports before discharging patients from their care.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.