New Campaign Targets Neonatal Safety

By Fernandez, Julio | Drug Topics, May 21, 2007 | Go to article overview

New Campaign Targets Neonatal Safety


Fernandez, Julio, Drug Topics


The use of intravenous (TV) syringes for non-IV applications such as enterai feedings poses many risks, especially for the pediatric and neonatal population, which has a majority of its oral and enterai doses provided through a gastric habe. Baxa Corp. recently announced the launch of a new educational campaign to make healthcare providers aware of these problems and to offer solutions. The campaign includes promoting the use of dedicated systems for enterai feedings and highlighting the risks to neonates when syringes, administration sets, and other disposables with luer fittings are used for enterai feedings.

On April 3, 2006, The Joint Commission (JCAHO) issued a Sentinel Event Alert, "Tubing misconnections-A persistent and potentially deadly occurrence," warning of the significant risk posed by tubing and catheter misconnection errors and offering strategies to reduce this risk. Tubing misconnections have the potential to result in serious injury or death, especially to neonates due to their small size and other complications. According to the alert, at least six deaths among infants and adults have been attributed to tubing misconnections. The Food & Drug Administration has received reports of enterai feeding tubes mistakenly connected to IV lines and tracheal tube pilot balloons.

Historically, gastric tubes used for neonatal and pediatric enteral nutrition and oral liquid medication administration have incorporated luer fittings to allow the use of hypodermie syringes to access the tube. Standard enterai and intravenous systems are similar in design and contain components that are compatible and fail to restrict the use of one system with another. This can lead to the accidental administration of enterai feeding into the bloodstream or intravenous medication to the digestive system.

"Many institutions that used IV syringes in the past for feedings have switched over to oral syringes. Oral syringes are definitely preferred for enterai feedings because they can prevent complications and potentially fatal errors," said Judith Scala, Pharm.D., pediatric/neonatal clinical pharmacist at Saint Peter's University Hospital in New Brunswick, NJ.

"This is a big process change. At our institution we use the Baxa oral syringes for enterai feedings. …

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