Parenterals Chapter 8

Parenterals Packaged as two general types of product: Large Volume Parenteral Solutions (LVP) Typically large bags containing large volumes of intravenous solutions. Small Volume Parenteral Solutions (SVP) Generally contained in ampules, vials, prefilled syringes & piggybacks. Must be sterile, free of particulate matter, pyrogen free, because it is injected directly into the blood stream.

LVP Solutions Intravenous solutions packaged in containers of 100ml or more. Piggybacks – 50-100ml volumes of fluid, typically infused over a period of 30 to 60 minutes with the administration of LVP solution.

Common LVP solutions Four solutions are commonly used as LVP solutions or as admixtures (LVP where a drug has been added). Sodium Chloride (salt) Dextrose Solution (sugar) Ringer’s Solution Lactated Ringer’s Solution

SVP Solutions Packaged products that are either directly administered to the patient or added to another parenteral formulations. Usually small quantities of 100ml or less

Syringes pg 206 Basic parts of a syringe are the barrel, plunger & tip. (needles are attached). Syringes come in sizes from 1ml to 60ml As a rule, the correct syringe size is the next size up from the volume to be measured. (2.5ml would use a 3ml syringe).

Needles Gauge of needle refers to the diameter of the shaft of the needle. The larger the number the thinner the needle. 27 gauge is the smallest 13 gauge is the largest 18 to 21 gauge are the most common Coring occurs with larger gauge needles as they damage the rubber closures of containers causing particles to fall into the solution & contaminate it.

Laminar Flow Hoods Microorganisms invisible to the eye are present in dust & particulate matter in the air and on most surfaces—even if they appear clean. Unless aseptic techniques are used to prepare parenteral solutions, contamination can easily occur. Laminar flow hoods create an ultra clean environment – the surfaces are clean, not sterile.

Preparing the Hood Turn on hood at least 30 minutes before use. Wash hands thoroughly Put on barrier clothing (mask, gowns, hair covers) & sterile gloves. Clean the inside of the hood with sanitizing solution. First clean the pole used to hang containers Clean sides using up & down motion starting back to front. Clean bottom using side to side motions from back to front.

Aseptic Techniques Collect supplies – remove dust before placing inside the hood. Position supplies smallest to the HEPA filter, larger further away. Make sure to space supplies to assure maximum exposure to flow. Swab all puncture surfaces with alcohol wipe before use.