Titrated intravenous opioids from the same syringe: an infection risk?
OBJECTIVE
(1) To compare the rate of contamination of syringes prepared under laminar flow conditions in pharmacy with those prepared by nurses in the emergency department; (2) to determine whether the time elapsed since preparation or number of doses given affected the contamination rate; (3) to determine whether any adverse effects resulted from bacterially contaminated drugs.


METHODS
Prospective, blinded trial exploring the effect of method of preparation, time since preparation, and number of doses given on contamination rates and infective adverse events associated with bacterially contaminated specimens.


RESULTS
The rate of bacterial contamination was 12% (95% confidence interval 6% to 18%). There was no difference in contamination rate in respect of method of preparation, number of doses given, or time since preparation. No infective complications were identified.


CONCLUSIONS
Abandonment of titrated intravenous opioids is not justified by the results. However, there is concern about the use of this technique of pain control for immunocompromised patients and those with prosthetic heart valves.
Taylor
M
M
Department of Emergency Medicine, Western Hospital, Footscray, Australia.
Bourke
J
J
Anderson
M
M
Davey
R
R
Kelly
A M
AM
Guthrie
B
B
D000698:Analgesia / Q000379:methods*; D001315:Australia; D016001:Confidence Intervals; D004340:Drug Contamination; D004636:Emergency Service, Hospital; D004866:Equipment Contamination; D017743:Equipment Reuse; D006801:Humans; D017053:Infection Control; D009294:Narcotics / Q000008:administration & dosage*; D010607:Pharmacy Service, Hospital; D011446:Prospective Studies; D011786:Quality Control; D013594:Syringes
D009294:Narcotics