Needle-free infusion connector is one of the important components in the infusion line. In the past two decades, it has inadvertently increased the risk of catheter related bloodstream infection.

Let's look at it from an infection control perspective

What are the design features of the infusion connector?

1.Surface of joint diaphragm

The smooth outer diaphragm surface can make the disinfection more thorough, reduce the problem that the gap around the piston is easy to colonize and there is a risk of infection.

 

 

2. Diaphragm sealing

The infusion connector is tightly connected with the screw infusion set or syringe to form a needle-free closed infusion system, which maintains the tightness and integrity of the vascular pathway and can reduce the chance of contamination.

 

 

3. Internal mechanism

The infusion connector with a simple internal structure, the most direct fluid path, and no moving parts reduce the risk of catheter-related bloodstream infections.

 

 

4. Liquid pathway

The vertical system infusion connector is conducive to sufficient flushing and reduces the risk of infection caused by bacterial colonization of the biofilm on the internal surface of the connector.

 

 

5. dead space

Directly related to the design of the fluid pathway, indirect or tortuous fluid pathways often form dead spaces that cannot be thoroughly flushed.

 

 

6. Clamping sequence
There are two types of mechanical valve infusion connectors: positive pressure and negative pressure, which cause different clamping sequences. The ideal infusion connector does not have a clamping sequence problem, or uses only one clamping sequence (for example, all negative pressure, all positive pressure or neutral pressure),

 

 

7. Make the medical staff operate correctly.

Standard operation method of positive pressure sealing tube for negative pressure infusion joint:

First clamp the tube clamp before disconnecting the syringe

Standard operating method for positive pressure sealing of positive pressure infusion joints:

Disconnect the syringe before pinching the tube clamp

 

 

8. Visibility

The transparent visibility is convenient for observing and evaluating the flow path, and can more directly judge whether the flushing tube and the sealing tube are thorough, reducing the adhesion and diffusion of bacteria at the joint and the pollution.

 

 

9. Blood return

Blood return increases the risk of catheter blockage and bacterial biofilm formation, and the ideal joint with its positive pressure design reduces or prevents blood backflow.

 

 

 

 

10. Rinse scheme

Some needle-free infusion fittings are designed to be flushed with heparin to reduce the risk of obstruction, and flushing with heparin may increase heparin-induced thrombocytopenia in some patients. Needleless infusion fittings that can be rinsed with normal saline instead of heparin-containing solutions avoid the potential risk of heparin-induced side effects.

Bloodstream infections are still the leading cause of morbidity and mortality in patients. What are we waiting for?

 

If prevention is the first step, action is essential. Grasp each level of good control and reduce the chance of bloodstream infection.

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