Evaluation of a double-enclosure double-vacuum unit scavenging system for ribavirin administration.
BACKGROUND
Because of our concern for the safety of bedside caregivers who care for infants receiving ribavirin for long periods of time each day for many days, we evaluated the effectiveness of a double-tent enclosure with vacuum scavengers during simulated and actual patient administration.


METHODS
Part 1--We sought to determine whether two or three scavenging pumps were necessary, by 3 8-h trials with 2 pumps and 3 8-h trials with 3 pumps. Entry into and replacement of mannequin occurred according to protocol. Continuous samples were obtained from three locations in the room. Part 2--The double-tent, double-pump scavenger system was evaluated with patient simulation for a 16-h period. Part 3--The double-tent, double-pump system was evaluated during actual patient use. Air samples were also collected during ribavirin administration via mechanical ventilator circuit with filters in the expiratory limb. Coded environmental samples were analyzed by liquid chromatography.


RESULTS
Environmental levels were effectively decreased below published maximal acceptable levels.


CONCLUSIONS
Use of a double-enclosure, double-pump scavenging system and implementation of entry protocols ensure reduction of environmental ribavirin levels below recommended maximum levels during administration to spontaneously breathing patients. Use of expiratory filters adequately controls environmental ribavirin levels during mechanical ventilation.
Massachusetts General Hospital, Boston 02114.
R M
RM
Kacmarek
J
J
Kratohvil
D000328:Adult; D000336:Aerosols / Q000008:administration & dosage* / Q000009:adverse effects; D000395:Air Pollutants, Occupational / Q000009:adverse effects; D001900:Boston; D003365:Costs and Cost Analysis; D003625:Data Collection; D004869:Equipment Safety; D005069:Evaluation Studies as Topic; D005260:Female; D015920:Gas Scavengers / Q000592:standards*; D006746:Hospital Bed Capacity, 500 and over; D006801:Humans; D007223:Infant; D016273:Occupational Exposure / Q000517:prevention & control*; D010564:Personnel, Hospital; D011358:Product Surveillance, Postmarketing; D011482:Protective Devices / Q000191:economics / Q000592:standards*; D012136:Respiratory Syncytial Viruses / Q000187:drug effects; D012254:Ribavirin / Q000008:administration & dosage* / Q000009:adverse effects; D014618:Vacuum