Irrigation Solution Lines Pose Hazard

M. Kumar, M.D.

To the Editor

The practice of hanging irrigation solutions (for cystoscopy, arthroscopy, and wound debridement) in close proximity to intravenous fluids poses many potential hazards to patient safety during anesthesia, especially during a crisis. The following drawbacks were observed in four teaching hospitals in the Buffalo area:

(i) Loss of valuable. time in starting inotropes and other cardiac drugs since the IV poles and hooks are preempted by irrigation fluid bottles.

(ii) Accidental withdrawal and use of irrigation solution as solvent for drugs in powder form.

(iii) Opening up the irrigation line stopcock instead of the IV line stopcock to increase the IV infusion rate.

(iv) Accidental injection of drugs into the irrigation tubing instead of the IV line.

(v) Masking of audio alarms by pulsatile jet irrigation device.

Apart from the above mentioned hazards, the irrigation system adds to the clutter and crowding of tubes and wires at the head end of the patient. Keeping the irrigation solutions well away from the immediate extra-personal space of the anesthesiologist will greatly improve the speed and efficiency of the anesthesiologist’s response to a -crisis and help -avert potentially dangerous mishaps.

M. Kumar, M.D. Buffalo, NY