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Nursing guidelines

BD Saf-T-Intima™ insertion guide

  • Note: This guideline is currently under review.

    This guide was created as part of the Clinical Guideline (Nursing): Subcutaneous Catheter devices; Management of Insuflon ™ and BD Saf-T-Intima™ devices

     

     Equipment


    • BD Saf-T-Intima™ catheter 24 Gauge (0.7 x 19mm) with Y adapter (Catalogue number 383313)
    • Transparent occlusive dressing, for example tegaderm or opsite
    • 1 or 3ml syringe
    • 10ml vial of Water for Injection or 0.9% Normal Saline
    • Alcohol wipe
    • Red caps
    • Local anaesthetic cream and transparent occlusive dressing (for example tegaderm or opsite), or ice if required (based on patient preference; local anaesthetic cream is the most effective)
    • Oral sucrose 33% should be used for procedural pain relief in infants aged less than 18 months of age. Refer to Sucrose (oral) for procedural pain management in infants clinical guideline


    NB: All orders for oral sucrose 33% and/or local anaesthetic cream must be documented on the patient’s Medicine Chart (MR690/A)

    Medications should be administered as per the Royal Children’s Hospital Medication Management Procedure http://ww2.rch.org.au/policy_rch/index.cfm?doc_id=6570

    Procedure

    1. Perform hand hygiene and assemble equipment
    2.  Prepare and explain the procedure to the child (if appropriate) and parents/caregivers
    3.  Select an insertion site refer to assessment in guidelines
    4.  If required, (based on patient age and preference), apply local anaesthetic cream to the site 30-60 minutes prior to insertion, or apply ice to the insertion site for 5 minutes until numb, or administer oral sucrose 33%.
    5.  After appropriate length of time has elapsed, open the package containing the BD Saf-T-Intima™, ensure that the pack is undamaged and sterile and within the expiry date
    6. Perform hand hygiene and put on non sterile gloves
    7. Clean the selected site with an alcohol swab and allow to dry
    8. Remove the white clamp from the BD Saf-T-Intima™ (to stop accidental clamping)
    9. Remove the flow control plug from the Y injection port to pre-prime the device, flush the BD Saf-T-Intima™ with at least 0.3mls of Water for Injection or 0.9% Normal Saline to ensure patency of the catheter device
      NB: The dead space volume of the BD Saf-T-Intima™ catheter is approximately 0.25 mls, ensure the flush used is compatible with the medications that will be administrated via the BD Saf-T-Intima™ catheter
    10. Remove needle cover and inspect unit
    11. Holding catheter as illustrated, rotate the safety barrel to loosen the needle 
    12. Make sure the bevel is oriented and not covered by the catheter; hold the pebbled sides of flange to ensure they are in contact with the skin surface when the catheter is inserted 
    13.  Pinch up the skin and insert the BD Saf-T-Intima™ into the subcutaneous tissue, advancing the total length of the catheter at a 20 to 45° (degree) angle to the skin surface. This should be done in one quick, smooth movement with the bevel facing up
    14. Release wings and stabilise with a transparent occlusive dressing, ensure the dressing is totally adhered to the skin to prevent bacteria from entering insertion site
    15. Place a small amount of pressure on the wings to ensure the catheter does not become dislodged and grasp the white shield and pull back slightly to recess needle
      NB: Do not reinsert the needle if the catheter is dislodged/withdrawn as this could shear the catheter, repeat the procedure with a new BD Saf-T-IntimaTM
    16. The needle shield will come off, exposing the infusion port with a plastic adapter insitu
    17. Dispose of the needle in a puncture-resistant, leak-proof sharps container
    18. Remove the plastic adapter (this is not required) from the infusion port of the straight arm of the BD Saf-T-IntimaTM
    19. If an infusion is being commenced connect the infusion directly to the straight arm of the BD Saf-T-IntimaTM and place a red cap on the Y injection port. If the BD Saf-T-IntimaTM is being used for breakthrough doses place a red cap on both infusion ports. Do not use smart sites
    20. Write date of insertion on the dressing
    21. Complete appropriate documentation; record the date, procedure and insertion site in the Inpatient Progress Notes MR660/A

     

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