Three-way stopcocks also permitted the aspiration of blood for laboratory tests. Their use enabled almost limitless access to the catheter for drug administration separate from a continuous infusion-and without degradation of the administration system. equipment armamentarium without significant announcement in the literature (possibly as they were adapted from existing drainage devices). Three-way stopcocks (taps) appear to have become part of the i.v. As more drugs with irritant pH or chemical composition were administered, there was an increased phlebitis risk one early report suggested that after 24 h most cannulated veins showed signs of phlebitis ( Anon, 1971). lines c.1970s was achieved with an administration set equipped with an integral injection bung, the frequent use of which led to leakage which enabled bacteria to enter and the infusate to flow out. Drug administration through established i.v. However, it was in the 1950s when significant and reliable developments were introduced to meet the needs of advanced healthcare. The first reported blood transfusion was in 1492 it resulted in a 400% mortality of a pope (the recipient) along with three 10-year-old boy donors ( Rivera et al., 2005). In the beginning there was nothing, which exploded. This first paper will consider NCs themselves, their design characteristics and the evidence for effective pre-access decontamination. The second paper will be an Outbreak Column which will appraise NC outbreak reports from the mid-2000s and subsequent (perhaps unnecessary) recommendations against a particular type of NC.
CRBSI will be the term used within this report unless a published paper specifically uses central line associated bloodstream infection (CLABSI).
It is the result of a rapid review of the available literature exploring the strengths and weaknesses of NCs related to the risks of catheter-related bloodstream infections (CRBSI). This paper seeks to provide clarity with regard to the available evidence and opinions. NCs are themselves ill-defined devices individual manufacturer’s designs have varying technical specifications which makes optimal product selection difficult. One critical piece of equipment is the needleless connector (NC) which connects to the end of the catheter enabling safe i.v. Although generally considered safe, intravenous (i.v.) access and drug administration remain potentially hazardous patient procedures with a vast array of possible errors and complications.
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