Download Sodium Chloride 0.9% for IV Flush

Sodium Chloride 0.9% for IV Flush
Staff Characteristics
Clinical Details
Registered Midwife
Clinical Situation for which
medicine is to be used
To maintain the patency of an intravenous device and act as a buffer
solution between different IV medicines
Clinical Criteria for inclusion
Women ≥16 years who have indwelling iv cannulae.
Clinical Criteria for exclusion
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Known hypersensitivity to any component of the medicine.
Individuals < 16 years of age.
When prescribed IV therapy that is incompatible with sodium
chloride 0.9%.
Management of excluded women
and those not wishing to receive
care
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Refer to medical staff as appropriate.
Document action / refusal in woman’s maternity handheld
record.
Use in pregnancy or lactation
May be used in pregnancy and lactation.
Cautions and/or reasons for
seeking further advice from a
doctor
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Woman fits exclusion criteria.
Woman suffers an adverse drug reaction.
Chronic dosing is required.
Woman declines medication.
Cautions and action that will be
taken if a caution applies
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Check for and document any allergies.
Check and document past medical and drug history and current
medication to ascertain potential for overdose.
If a caution applies consult with a doctor.
Document consultation in woman’s maternity handheld record.
Refer to current BNF for latest information on interactions.
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Description of Treatment
Name / Form / Strength of
Medicine
Sodium Chloride / Injection / 0.9%
Dosage
5-10ml
Route of administration
Intravenous
Frequency of administration
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Twice daily to maintain patency where no infusion or bolus
injections are being used (unless prescribed otherwise).
If bolus injections or intermittent infusions are being
administered the flush should be given before giving a bolus
injection; in between two different IV medicines, as a buffer; and
after the administration of the bolus injection or intermittent
infusion.
Duration of treatment
As per local Trust guidelines.
Legal Status
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POM – midwife may administer as medicine is on midwives
exemption list.
Storage requirements
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Should be stored at room temperature and protected from
excessive heat and freezing.
Warnings
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Do not use excessive force when attempting to flush an IV
device as this may risk a thrombus being pushed into the
circulation.
To minimise coldness/ pain on injection: give slowly.
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Follow –up
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Refer if cannula is blocked then it must be resited.
Refer if prescribed IV therapy is incompatible with sodium
chloride.
Refer if woman develops side/adverse effects or if there is an
inadequate response.
Refer immediately in case of overdose.
Undesirable effects
Injudicious intravenous saline therapy may cause hypernatraemia.
• If a serious adverse reaction is suspected please report to the
MHRA Yellow Card Scheme http://yellowcard.mhra.gov.uk/
Overdose
Injudicious intravenous saline therapy may cause hypernatraemia.
General adverse effects of sodium chloride excess in the body include:
nausea, vomiting, diarrhoea, abdominal cramps, thirst, reduced
salivary and lachrymal secretions, sweating, fever, hypotension,
tachycardia, renal failure, peripheral and pulmonary oedema,
respiratory arrest, headache, dizziness, restlessness, irritability,
weakness, muscular twitching and rigidity, convulsions, coma and
death. Excess chloride in the body may cause a loss of bicarbonate,
with an acidifying effect.
• Immediate assessment / treatment is essential – refer to
medical staff.
• Manage in accordance with established treatment guidelines or
see BNF overdose section.
• For further advice contact National Poisons Centres
0844 892 0111.
Advice to be given to the woman
Monitoring arrangements during
and after treatment and follow-up
required.
Records to be kept
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Explain treatment and course of action.
Side effects explained.
Verbal consent obtained before administration.
It is good practice to offer the woman the manufacturer’s
Patient Information Leaflet to support any verbal advice
provided.
If the woman suffers a serious adverse drug reaction, seek
immediate medical assistance.
• Monitor for side effects and effectiveness.
• To be reviewed by doctor if inadequate response.
Must be written in the once only medicines and pre-medications
section of the medicine kardex. The person who writes up the
medication must write their designation after their signature e.g.
Midwife Band (*). Also record the administration, date, time and name
of practitioner in the relevant section of the woman’s maternity
handheld record.
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References
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Sodium Chloride 0.9% SPC Hameln Pharmaceuticals Ltd 2nd
February 2010 www.medicines.org.uk
Intravenous Therapy in Nursing Practice Second Edition edited
by Lisa Dougherty, Julie Lamb