When IVFE is administered intermittently, use a new administration set with each infusion.Ħa Scrub the catheter port with appropriate antiseptic for 15 seconds.ĭecreases potential of introducing pathogens because there is a greater potential for pathogen growth and contamination as a result of the dextrose and protein content of the solution.Ħb Flush infusion device with normal saline (0.9% NS) and check for patency. Administration sets that have been used for PN and have a piggybacked IVFE must be changed every 24 hours. Immediately report any signs or symptoms of infection to the healthcare prescriberĥa If tubing does not have micron filter, add 0.2-micron filter to the tubing.ĥc Prime the tubing according to the manufacturer’s directions.ĥd Attach to electronic infusion device according to the manufacturer’s directions.Ĭhange administration sets, using aseptic technique, no more often than every 96 hours without fat emulsion and immediately upon suspected contamination or when the integrity of the product or system has been compromised to help reduce chance of bacterial growth. Reduces incidence of solution being administered to the wrong child.Ĥ Examine the infusion device and site for type, placement, patency, and signs of infection. Match identification with label on the solution bag. Reduces chance of child receiving incorrect or contaminated solution.ģb Identify the child utilizing two different patient identifiers. Do not infuse if the solution has expired, is cloudy, has crystals, or has leaks. Examine solution and container for clarity, signs of contamination, or particles. Verify label against the healthcare prescriber’s orders. Microwaving may cause the solution to heat unevenly and deterioration of components within the solution.ģa Inspect solution. Never warm the solution in a microwave use warm water bath if necessary. Infusing a cold solution may cause hypothermia. Reduces transmission of microorganisms.Ģ Place the solution bag on clean work surface. Promotes efficient time management and provides an organized approach to the procedure. The changes in the particle size observed with some drugs suggest that they may cause changes in the lipid particle size during administration and, therefore, those antibiotics agents should not be administered concurrently with fat emulsion.Īntibiotics Compatibility Fat emulsion Injection Piggyback infusion.1 Gather the necessary supplies. The particle size in the mixture containing gentamicin sulfate, arbekacin sulfate, minocycline hydrochloride, ciprofloxacin, and fosfomycin sodium changed significantly after preparation. The particle size in the mixture containing vancomycin hydrochloride, levofloxacin hydrate, metronidazole, and fluconazole gradually increased after preparation. No marked changes were observed in the 12 β-lactam antibacterial drugs, clindamycin phosphate, teicoplanin, trimethoprim/sulfamethoxazole, and micafungin sodium even at 24 h after preparation. Test mixtures of 5% glucose solution, fat emulsion, and 25 antibiotic agents were prepared in the ratio appropriate for piggyback infusion (33: 10: 40) and analyzed serially for the number of fine particles by size using a light-shielded automatic fine particle counter. We tested the compatibility of fat emulsion with antibiotics in piggyback infusions in terms of changes in the size distribution of fat particles. The Guidelines for Parenteral and Enteral Nutrition in Japan state that parenteral fat emulsion can be infused through a secondary administration set.
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