12 ml syringes

[willowtreewren]

 
I picked up the next month's supplies at our clinic yesterday and opened up the syringes to start using them today. The dang things don't have caps on the end anymore to keep them sterile. Ichecked the second box, thinking that perhaps I had gotten a defective box. the ssecond box was without caps, too.

 I called the clinic to see if perhaps I had gotten the wrong ones. It was the first they had heard about the problem.

My guess is that the manufacturer (Kendall) is cutting corners. So, to maintain sterility, it is necessary to leave the syringes in the plastic wrapper until ready to use them. NOT very convenient at all. The tech at the clinic worried that some folks will simply take them out and not keep the ends sterile.

I get frustrated when money saving strategies put people's lives in danger.

 

Aleta

[Adam_W]

I've always gotten capless syringes, except for the ones that come with a needle. It is inconvenient, but I've gotten used to just leaving them in the wrapper until I need them. My syringes come from BD. I can understand the concern that some people might remove the wrapper and not cap the end.

Adam

[monrein]

My syringes never had caps either and like Adam I used the sterile wrapper as the "cap".  Fill with saline, stick back in the wrapper until time to attach to wherever.

[Dan.Larrabee]

Aleta,

You have some sterile caps you can use. I know you are a user of NxStage, so just take the caps off the MLA when you connect up your dialyisate bags next tx. If you are using 4 bags, that gives you 4 caps and when you are done with your tx, you have the extra 2 caps you can use. I got in the habbit a long time ago of taking the cap off the MLA and the cap of the dialyisate bag and connecting them together. I have a bucket full now.

I know you are going on PureFlow soon, so this is only a short term fix.

[swramsay]

Mine don't have caps either. I take off and toss the paper part of the wrap and leave the syringes cradles in the plastic part of the wrap until I connect the syringes to saline red and blue clamps. When I need saline at the end of the run, the syringes are already attached to the saline bag and still sterile.

[willowtreewren]

Great idea, Dan.

Capping the two parts together is a clever way to keep them sterile. Hmm. Better start saving them now as I only have a couple weeks left....

Wendy, that's a good idea, too. It would be less viable for me, though because my husband and I are both getting the machine set up (saves time). Those syringes would be sitting on top of the cycler while he would be doing the snap and tap. I'm very particular about leaving things exposed like that. Don't want a nasty infection...

You know, you get so used to "muscular memory" that it is hard to make some of those subtle changes. When it was time to do the hook-up today I pulled the syringe out of the sleeve, but there was no blue cap to remove and it threw me off by not having to make my slight turn to toss it. Felt unsettled for the rest of the connection!

I'll get used to the new routine, even though it may not feel as convenient.

Monrein, I don't need to "store" syringes with saline. Once I draw the saline I attach the syringes to the needle lines. It is mostly the empty syringes waiting to replace the connections where the treatment lines are connected waiting for hook-up to my husband.

I don't see it as too much of a problem during regular tx, but when I'm doing the Kt/V, it is going to be very cumbersome. There are just so many bits to juggle, a plastic sleeve will make it that much trickier.

Sigh.
Aleta

[monrein]

Oh Aleta, heavens no I wasn't suggesting you'd store them like that.  I used to fill my syringes and have them ready to hook up but sometimes I'd have some other things to do while priming, so they just be there for a couple of minutes.   I never used Nxstage, so I'd fill my syringes from the first priming bag of saline then attach my second bag and finish my priming before hooking syringes to needle lines.  The packages were our caps.

[willowtreewren]

 

Hi, Monrein. I used the term "store" meaning that I never need to re-cap a syringe with saline already in it. 

I'm just spoiled. Until today I could rip open those five syringes that I use every day and drop them on my chux. Then slap two on top of my cycler waiting to connect them to the saline spike after disconnecting the treatment lines, draw the heparin into a third syringe, draw saline into a fourth, switch the needle to a fifth syringe, attach that saline syringe to the needle line and flush it, draw the second syringe of saline and attach it to the second needle line and flush it. I even have a protocol for keeping the micro-bubbles to a minimum. Even so, I attach the first saline syringe to the arterial needle since it tends to have more micro-bubbles.

I've worked out this very efficient dance of preparation and pared the time down as much as possible. I have to be able to do this after a long day of work. We have honed this process down to the point that I can push the start button on the machine 45 minutes after leaving work. Then I only have 3 and  a half more hours before we can say, "done."

I shouldn't whine about a few extra steps and a little less convenience. But once spoiled by sterile caps, it's hard to be happy by their loss. 

Monrein, I so appreciate your voice of wisdom. I could never see you with a row of saline syringes stored in the plastic sleeves.  (I sure wish you could "hear" the humor in my voice.)

Aleta

[monrein]

 

You're so right about how attached we are to our routine ways of doing things.  I could have hooked those saline syringes up directly too, but no, that wasn't the order I did it in.  I'm glad you can't "see" me with rows of stored syringes.   

BTW...those cannulation needles (the bigger the better) and a 20cc syringe are a great way of injecting a marinade into a roast.  Just be sure never to reuse needles one way or the other.  I sure hope also that you can "hear" the humour in my voice.   

[jbeany]

We always attached ours to the ports on the saline bag, filled them and left them on the ports until we needed them.  while setting up, before the ports on the saline were ready - I just opened the plastic wrap at the ends, and left the syringe inside the wrap.  Easier to grab, but still in the sterile pack.

[willowtreewren]

Hey everyone. 

So, today during my set-up I tried incorporating all the great ideas.

Wendy, for the two syringes on top of the machine I modified your idea of tearing off the paper and leaving them in the plastic trays. I just tore the paper off half way down. They will be easy to grasp with the paper gone from the top half, but they are still protected! Thanks.

Dan, I started gathering up the little caps and combining them so I have some sterile caps for when I have to do the Kt/V. Your tip helped me find some that will be available even after we switch to Pureflow.

Monrein, I can hardly wait to marinate. 

Thanks, everyone.

Aleta