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A case of needle-free delivery system incompatibility.

It has become standard practice to use closed, needle-free connectors on peripheral intravenous lines to reduce needle-stick injuries1. However, there have been compatibility issues reported in recent literature. For instance, the use of pre-filled syringes is incompatible with the CLAVE connectors2.

We report a further equipment incompatibility between the V3-GISS triple lumen peripheral set from Go Medical Industries (Subiaco, WA) and the Smart Site needle-free valve port 200E from Alaris (Dublin, Ohio, USA) (Figure 1). This incompatibility was encountered during the recent case of a 70-year-old male, ASA II, undergoing cystocopy and transurethral resection of the prostate. An 18-gauge BD Insyte catheter with a Smart Site needle-free valve port 200E was inserted into a superficial vein on the dorsum of the right hand. A V3-GISS triplelumen peripheral set was connected to this port with a 1 litre bag of compound sodium lactate connected via an administration set to the primary arm of the peripheral set. The patient underwent a single-shot spinal with 3 ml of 0.5% bupivacaine and, following repositioning, was commenced on a propofol target-controlled infusion at 1.2 [micro]g/minute for sedation. The propofol was connected to the fluid giving set port. Approximately five minutes after commencement of the target-controlled infusion, the patient's systolic blood pressure was recorded at 89 mmHg from a starting pressure of 140 mmHg. It was decided to give a 0.5 mg bolus of metaraminol via one of the two spare lumens on the V3-GISS triple-lumen peripheral set. However, neither of these ports was usable. As a result, the propofol had to be temporarily ceased to enable the administration of metaraminol.

[FIGURE 1 OMITTED]

On connection on the V3-GISS triple lumen set directly to the BD Insyte cannula, following removal of the Smart Site needle-free valve port 200E, all three lumens were useable. We note with interest that the triple-lumen peripheral sets manufactured by Alaris are compatible with the needle-free valve port 200E. We suggest that this incompatibility needs to be more widely recognised.

References

(1) Russo PL, Harrington GA, Spelman DW. Needleless intravenous 1. systems: a review. Am J Infect Control 1999; 27:431-434.

(2) McCallum SR, Graham GR, Sigston PE. Blocked syringe with 2. use of needle-free connector. Anaesthesia 2007; 62:94-95.

J. D. Doyle

R. H. Riley

Perth, Western Australia
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Article Details
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Author:Doyle, J.D.; Riley, R.H.
Publication:Anaesthesia and Intensive Care
Article Type:Report
Geographic Code:8AUST
Date:Jul 1, 2009
Words:382
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