The contamination of intravenous fluids by writing on the infusion bag: Fact or fiction?

Abstract

Introduction -Laboratory experiments were conducted to ascertain whether Sharpie® brand black permanent marker ink will permeate through intravenous infusion bags. The practice of writing directly on infusion bags is a frequent yet controversial practice. There are no known written standards that exist which pertain to this practice. Methods -Five types of intravenous bags containing different solutions marked with black ink from a fine point felt tipped Sharpie® marker. Sample extraction occurred after infusion bags had been warmed to 40 C or remained ambient. Spectrophotometric scans and measurements were conducted at 300 to 600 NM on each solution contained in the experimental bags. Writing with Sharpie® pens on filter paper and surgical tape was also conducted. Results -A total of 17 experiments were conducted with intravenous bags of five different types of manufacture. There appeared to be no visible or ultraviolet spectrophotometric evidence of leaching of the ink from Sharpie® pens. Four different lot numbers of Sharpie® pens were used. Surgical tape that was written on using Sharpie® markers readily exhibited visible evidence of permeability. Discussion -The experiments conducted would appear to indicate that the infusion containers tested maintained an intact barrier to the application of Sharpie® brand permanent marker ink. Writing on surgical tape does not stop the permeability of Sharpie® pens. This study could serve as a suitable pilot study for others to conduct a much more comprehensive study using a greater number of intravenous containers, solutions and ink markers.

The effects of pen ink and surface disinfectants on red blood cells stored in plasticized polyvinylchloride transfusion bags

“…6 Visible and ultraviolet spectrophotometry has also shown that the Sharpie pen is safe to use on PVC infusion bags. 1 In our study, electrospray ionization-MS generated results that were consistent with those of the previous studies wherein ink was not seen to permeate PVC bags. Unlike the previous reports, which used PVC bags filled with saline, our measurements were made on PVC bags filled with red cell concentrate.…”

“…At many hospitals, blood component bags may be altered after issue from the protected setting of a blood bank to clinical areas. Two such examples in hospitals include (1) bags being marked with a pen for the information of the clinical team, including indicating they have been double-checked for identification, and (2) bags being returned from areas with infectious precautions which may require disinfection for infection prevention and control. These alterations may have impacts on the quality of the blood component, most common in red blood cell (RBC) units, given the semi-permeable nature of blood component bags.…”

“…4 The previous studies that demonstrated no evidence of the ink from felt-tip markers diffusing through intravenous polyvinyl chloride (PVC) bags were limited to felt-tip markers and did not consider the use of other types of pens. 1,5,6 Thus, though standards are appropriate in discouraging pen marks on component bags, the effect on RBC quality is unclear and may not justify the discard of these units.…”

“…These alterations may have impacts on the quality of the blood component, most common in red blood cell (RBC) units, given the semi‐permeable nature of blood component bags. As far as we are aware, previous studies that assessed the permeation of ink through infusion bags used crystalloid solutions inside the bags, not red blood cell concentrate, and the safety of this practice on RBCs has not been evaluated so far 1 . Thus, when RBC component bags are exposed to pen marks and/or infectious environments and are returned to the blood bank, they may be discarded to prevent the putative deleterious effects on RBC quality from affecting the subsequent patient they are issued to.…”

Identificación de bacterias presentes en tres soluciones intravenosas en un período de 72 horas

“…La terapia con fluidos intravenosos está prescrita como parte del tratamiento en la mayoría de animales en condiciones clínicas críticas [18]. Los cristaloides, en especial el lactato de Ringer y cloruro de sodio al 0,9 % se administran con el principal objetivo de mantener o restaurar el volumen vascular y la perfusión tisular [12]. En la actualidad, la administración de fluidos se basa en las necesidades de cada paciente [6,13,14].…”