Antineoplastic Agents - Part 2

Summary

This instructional script outlines the step-by-step process for handling chemotherapy and antineoplastic solutions, focusing on precise techniques for withdrawing, injecting, and reconstituting medications. It emphasizes the importance of maintaining sterility, preventing contamination, and using proper tools, such as syringes, filters, and needles. The guide details procedures for handling vials, ensuring accurate fluid volume, preventing air bubbles, and managing negative pressure techniques. Safety measures, including the disposal of used equipment and the correct handling of hazardous materials, are also covered, ensuring safe and efficient medication preparation for healthcare professionals.

Takeaways

• 😀 Ensure the filter does not get wet when withdrawing excess fluid into the syringe by injecting the excess volume slowly back into the vial.
• 😀 When detaching the syringe from the chemotherapy dispensing pin, firmly hold the vial at a 45-degree angle to avoid contamination.
• 😀 Always draw up fluid from the syringe tip to prevent the antineoplastic solution from leaking onto your hands.
• 😀 Attach a needle to the syringe before expelling air bubbles to avoid spraying the HEPA filter.
• 😀 When inserting air into the syringe to remove bubbles, make sure to avoid contamination by handling the needle properly.
• 😀 Disinfect the injection port of the solution bag thoroughly before injecting the antineoplastic product.
• 😀 The solution bag should be tested for integrity by gently pressing on it after the injection to ensure no leaks.
• 😀 When reconstituting powder, avoid injecting the diluent too quickly, as it could generate foam and block the filter.
• 😀 Always maintain pressure on the syringe plunger while removing it to avoid fluid leakage or contamination.
• 😀 Ensure no air bubbles remain in the tubing by tapping it and flicking any trapped air upwards before proceeding.
• 😀 After reconstitution, check the solution to ensure it is fully dissolved and free of foam or particles before making withdrawals.

Q & A

Why is it important to inject the excess volume of fluid slowly back into the vial?

Injecting the excess volume slowly back into the vial helps avoid wetting the filter, which can affect the sterility and effectiveness of the procedure.

What is the purpose of holding the syringe with the tip upward when detaching it from the chemotherapy dispensing pin?

Holding the syringe with the tip upward helps to prevent any fluid from leaking out, ensuring that the antineoplastic solution doesn't run onto your fingers.

Why is it necessary to draw two centimeters of air into the syringe before injecting the fluid?

Drawing air into the syringe helps prevent the antineoplastic fluid from leaking into the needle guard, maintaining the integrity of the fluid and the syringe.

What should you do if the amount of fluid in the syringe is insufficient?

If the amount of fluid is insufficient, you should withdraw the missing volume from the vial to ensure the correct amount of fluid is prepared.

What is the procedure for attaching tubing before injecting an antineoplastic solution?

Before injecting the solution, disinfect the injection port of the solution bag, attach a needle to the end of the tubing, and insert it into the bag while avoiding contamination. Then, clamp the tubing about 45 cm from the flow chamber.

Why should you avoid rapid injection of diluent when reconstituting an antineoplastic powder?

Injecting the diluent too quickly can generate foam, which may back up into the venting needle and block the hydrophobic filter, compromising the reconstitution process.

How do you prevent contamination when handling the filter during reconstitution?

To prevent contamination, avoid removing the filter from its packaging until it is attached to the syringe, ensuring that it remains sterile throughout the process.

What is the negative pressure technique used for when reconstituting antineoplastic products?

The negative pressure technique is used when the appropriate reconstitution devices are not available. It helps create a controlled environment during the injection and minimizes exposure to hazardous aerosols.

Why is it important to check for air bubbles in the tubing after attaching it to the solution bag?

Checking for air bubbles is important because trapped air can affect the infusion rate and result in inaccurate dosing or incomplete administration of the solution.

How can you prevent leaking of the solution when preparing and handling the vial during reconstitution?

To prevent leaking, ensure that the diluent needle stays out of the solution, avoid creating overpressure in the vial, and maintain a gentle, rotary motion to dissolve the powder without disturbing the stopper or causing leaks.