IV fluid overfill in sterile compounding and basics of venous access

venous catheters

• peripheral lines

• central lines

peripheral lines

• admin of most IV meds

• simpler to insert than central lines

• inserted into smaller veins

• admin of IV med, fluids, blood transfusion

peripheral line limitations

• vein irritation: vesicant meds

• venous thrombosis

• fluid extravasation: dislodged catheter

central lines

• empties into a larger vein

• contents are quickly diluted

• admin of larger volumes

• faster infusion rates

central lines are used to admin ____

• highly concentrated substances

• long-term antibiotics

• meds that could cause severe phlebitis

• parenteral nutrition

types of central line

• central line

• peripherally inserted central catheter

where are central lines inserted

into internal jugular vein, subclavian vein, or femoral vein

clos proximity to large vessels and do not require long catheters

peripherally inserted central catheter (PICC)

• into peripheral vein and advanced into the superior vena cava

• may be placed at bedside

vesicant

substance that can cause severe tissue damage, including blistering and necrosis, it if leaks out of the vein into surrounding tissue

vesicant agents

• dopamine and norepinephrine 

• doxorubicin

• vincristine and vinblastine

• digoxin

• promethazine

why is overfill used in commercial containers

to compensate for fluid loss, manufacturers add overfill to the containers

overfill in volume in commercial IV bag agents

• Baxter 100ml

• Baxter 1000ml

• Hospira 1000ml

Baxter 100 mL

actual volume ranges from 105 mL to 115 mL

Baxter 1,000 mL

actual volume ranges from 1,030 mL to 1,070 mL

Hospira 1,000 mL

volumes ranged between 1,035 mL to 1,038 mL

what happens with overfill in vials

leads to dosing errors if overfill is not taken account

overfill in vials agents

• Alimta (pemetrexed)

• Torisel (temsirolimus)