Reply To: Closed system infusion devices

  • Amanda Lulloff

    Member
    March 29, 2021 at 10:41 am

    Hello,

    We’re having problems with Texium and Alaris tubing disconnects. Most of our tubing is bonded, so it can’t disconnect. But when we need to use a non-bonded piece, we have disconnect issues. 

    We’re also having problems with our Alaris tubing in general. There has been some bubbling/exploding/leaking of the soft part that runs through the tube. Recently they’ve been entrapping air below the level of the pump when the channel is turned off and primary tubing is attached to a short set (unsure if this is a pump issue or a tubing issue). And a lot of our bifuses, trifuses and needless connectors are cracking/breaking. 

    Reported all issues to BD. They do not believe any of it is manufacturing issues and want to retrain staff. 

    ——————————
    Amanda Lulloff, PhD, ARNP-CS, PCNS, CPHON
    Seattle Children’s Hospital
    Clinical Nurse Specialist Cancer Care Unit
    ——————————
    ——————————————-
    Original Message:
    Sent: 03-29-2021 07:20 AM
    From: Mindy Bibart
    Subject: Closed system infusion devices

    Great question Mary Lynn. there is definitely a weak point between the Alaris connection and spiros connection. When we met with the ICU Medicine reps a couple of weeks ago, this was a point of discussion. Although I can’t remember the terminology for insuring parts are luer locks are compatible, there is a measurement with a range that is appropriate. We are concerned that there may have been changes/improvements to pieces that make them incompatible, or variabilities within manufacturing that is creating pieces outside of the acceptable range. I am displeased with Alaris on many levels, although changing out our infusion pumps would be a herculean undertaking. I hope it doesn’t come to that!

    ——————————
    Mindy Bibart, MSN RN CPHON NE-BC CSSBB
    Director of Patient Care Services, Hematology/Oncology/Blood and Marrow Transplant
    Nationwide Children’s Hospital
    Columbus, OH
    ——————————

    Original Message:
    Sent: 03-26-2021 05:58 PM
    From: Mary Lynn Rae
    Subject: Closed system infusion devices

    I wonder if anyone out there is having any issues with other CSTDs and the BD/Alaris tubing? I am thinking it is more the BD/Alaris tubing with the spin collar on the end vs. CSTDs

    Mary Lynn
    Mary Lynn Rae, MSN, RN, CPHON, NPD-BC
    NPD Practitioner/Clinical Educator:  Hem/Onc/SCT (LC17/LC18)
    Ann & Robert H. Lurie Children’s Hospital of Chicago
    225 E. Chicago Avenue
    Chicago, Illinois  60611
    Phone:  312-227-4224
    Pager:  312-227-4000, ask for pager 74224
    email:  mlrae@luriechildrens.org

    Original Message:
    Sent: 3/26/2021 1:58:00 PM
    From: Heather Cantrell
    Subject: RE: Closed system infusion devices

    We are currently deciding between Equashield and Chemoclave. Equashield has a locking adapter that will be done with production this summer, leaving only the microclave as a potential disconnect site. The team likes the chemoclave ease of connection. We have used spiros for many years with minimal disconnects. I am curious what other hospitals prefer.

    ——————————
    Heather Cantrell, RN
    Dayton, OH
    United States

    Original Message:
    Sent: 03-26-2021 12:26 PM
    From: Mindy Bibart
    Subject: Closed system infusion devices

    ​We are considering changing products for our closed system infusions devices. We currently use ICU Medicine’s spiros products and continue to struggle with line disconnections. What product lines are you using and what are the pros and cons of that system.

    Thank you,
    Mindy​​

    ——————————
    Mindy Bibart, MSN RN CPHON NE-BC CSSBB
    Director of Patient Care Services, Hematology/Oncology/Blood and Marrow Transplant
    Nationwide Children’s Hospital
    Columbus, OH
    ——————————