All ONS Member Community

Expand all | Collapse all

Closed System Transfer Device

  • 1.  Closed System Transfer Device

    Posted 11-20-2018 21:09

    Our Ambulatory infusion Center recently changed our closed system transfer device to ICU Medicals Chemo lock.  Our nurses have questioned the amount of medication left in the device connectors when giving a subcutaneous injection.  There is approximately 0.4ml left in the connectors that is not visible.  Is anyone using this device and if so how are your giving your injections?

     

    Valerie Quigley, BSN, RN, OCN, HN-BC

    Valley Mount Sinai Comprehensive Cancer Care

    One Valley Health Plaza

    Paramus, NJ  07652

    201-634-5714

    vquigle@valleyhealth.com

    vhs_mtsi_ccc_2106_4C

     

     



  • 2.  RE: Closed System Transfer Device

    Posted 11-21-2018 07:34
    ​We do have Palliative Care Programs in outpatient setting. I have not actually been over to the clinic, however I do not believe they store scheduled drugs in the clinic. We have a pharmacy in the building where the clinic is ( hospital medical center), so it is easy for the patients to obtain what they need as prescriptions are written. Michigan has new scheduled drug management laws.

    ------------------------------
    Sandra Remer
    Neuro-Oncology Coordinator
    Farmington Hills MI
    ------------------------------



  • 3.  RE: Closed System Transfer Device

    Posted 11-21-2018 10:29
    Hi Valerie
    The information I was provided was 0.3mL, but we also faced the same question.

    Our solution was to use the ICU Spiros for injections. It has a dead space of 0.1mL. Since all SQ medications require a needle, this was an intuitive change for staff who also appreciated not requiring a adapter at the end of the syringe. We DO use ChemoLock for our IV hazardous drugs.

    Seth

    ------------------------------
    Seth Eisenberg RN ADN OCN BMTCN
    PROFESSIONAL PRACTICE COORDINATOR, INFUSION SERVIC
    Seattle Cancer Care Alliance
    Federal Way WA
    ------------------------------



  • 4.  RE: Closed System Transfer Device

    Posted 11-21-2018 10:34
    I honestly don't remember what closed access transfer device we use but what I have learned from one of my coworkers is to back prime a couple of mLs to clear the device before disconnecting it.

    ------------------------------
    Michelle Loose
    Rush University Medical Center
    Chicago, IL
    ------------------------------



  • 5.  RE: Closed System Transfer Device

    Posted 11-21-2018 10:36
    I apologize, I didn't read carefully enough to see you were talking about subq injections.

    ------------------------------
    Michelle Loose
    Chicago IL
    ------------------------------



  • 6.  RE: Closed System Transfer Device

    Posted 11-23-2018 09:42
    ​Thank you for your response.  What do they do for IM/SC injections?

    ------------------------------
    Valerie Quigley BSN RN
    Infusion Manager
    Pompton Lakes NJ
    ------------------------------



  • 7.  RE: Closed System Transfer Device

    Posted 11-25-2018 16:03

    Thank you for your response.  What do they do for IM/SC injections?
    Valerie Quigley,  11-23-2018 09:41
    Hi Valeria
    Not sure if I understand your question. Sorry!

    Seth

    ------------------------------
    Seth Eisenberg RN ADN OCN BMTCN
    PROFESSIONAL PRACTICE COORDINATOR, INFUSION SERVIC
    Seattle Cancer Care Alliance
    Federal Way WA
    ------------------------------



  • 8.  RE: Closed System Transfer Device

    Posted 11-27-2018 10:06
    The CSTD dead space is accounted for when our injections are prepared by adding the dead space volume to the total volume prepared.

    Susan

    ------------------------------
    Susan Poindexter BSN, RN, OCN
    Nurse Education Coordinator
    Wake Forest University Comprehensive Cancer Center
    Winston-Salem NC
    ------------------------------



  • 9.  RE: Closed System Transfer Device

    Posted 16 days ago
    Dear Valerie Quigley,
     My name is Suwannee Sirilerttrakul, APN  from Thailand.  I have some breast cancer who need to administer Trastuzuma SC.  As the NIOSH recommendation to prepare a immunotherapy under BSC classII carbiner or  CSTD.  CSTD is new of us to prepare Trastuzumab subcutaneous. My courious  are:
    1. In the end process of drawing a drug by  using transfere device: Do you  disconnect  CSTC then put the needle on syringe for injection ( this process are open system, it can let exposure!)?  Or you have the special tranfer device which do not  need to disconnect before putting the needle  on the syring?
    2. Yes, it still have the remaining of  the drug amount .03 ml while using transfer device. Trastuzumab  SC is so expensive!
    3.  Do you have any CSTDs  recomment to use for prepartion (subcutaneous injection)? I just tried  with Surplug ChemoAccess (Terumo) and Mino Spike( BBRAUN)
    Thank so much/Suwannee

    ------------------------------
    Suwannee Sirilerttrakul RN APN
    Bangkok
    ------------------------------