Unit 2 - Contamination

Question 1

Give examples of contaminants that could be found in IV fluids

Answer 1

Particles
- intrinsic
- formulation
- extrinsic
- environment
Air
Microbes and their associated endotoxins

Question 2

Give examples of intrinsic sources of IV contaminants

Answer 2

Infusion fluids or additives
Punctures/cracks in delivery containers
Vacuum-seal of bottles
Infusion delivery sets
Set ports
Disinfectants and catheter dressing

Question 3

Give examples of extrinsic sources of IV contaminants

Answer 3

Container changes
Air-vents
Delivery set changes
Bolus or concurrent injections/infusions
Catheter insertion or manipulation
Connectors
Drug Interaction-Precipitation

Question 4

What factors are associated with the patho-physiological effects of particles?

Answer 4

Site of infusion of particles
Size of particles
Dose of particles
Material of particles
Host factors

Question 5

Give an example of a problem with peripheral TPN

Answer 5

Thrombophlebitis
- same effect in IV drug users
- especially if cut with talc

Question 6

What is a particulate contamination of injections and infusions?

Answer 6

Extraneous, mobile undissolved particles, other than gas bubbles, unintentionally present in the solutions

Question 7

How are sub-visible particulate contaminations identified?

Answer 7

Method 1 - light obscuration
Method 2 - microscopy

Question 8

How are visible particulate contaminations identified?

Answer 8

Visible particles

Question 9

What did the FDA safety alert (18/4/1994) state?

Answer 9

A filter should be used when infusing either central or peripheral nutrition admixtures

Question 10

How is air removed from a filter?

Answer 10

The intravenous fluid with entrained air enters the filter inlet and flows to the lower chamber
Entrained air passes through the hydrophobic filter membrane and is vented automatically
IV fluid will pass only through the hydrophilic filter membrane to the upper chamber