Non-Injectable Sterile Fluids

NON-INJECTABLE STERILE FLUIDS

There are many other types of solution in a sterile form, for use particularly in hospitals.

A)   Non-Injectable Water

This is sterile water, not necessarily of injectable water standards, which is used widely during surgical procedures for wound irrigation, moistening of tissues, washing of surgeons’s gloves and instruments during use and, when warmed, as a haemostat. Isotonic saline may also be used. Topical water (as it is often called) is prepared in 500 ml and 1 l polyethylene or polypropylene containers with a wide neck and tear-off cap to allow for ease of pouring.

B)    Urological (Bladder) Irrigation Solutions

These are used for rinsing of the urinary tract to aid tissue integrity and cleanliness during or after surgery. Either water or glycine solution is used, the latter eliminating the risk of intravascular haemolysis when electrosurgical instruments are used. These are sterile solutions produced in collapsible or semirigid plastic containers of up to 3 L capacity.

C)   Peritoneal Dialysis And Haemodialysis Solutions

Peritoneal dialysis solutions are admitted into the peritoneal cavity as a means of removing accumulated waste or toxic products following renal failure or poisoning. They contain electrolytes and glucose (1.4–7% w/v) to provide a solution equivalent to potassium-free extracellular fluid; lactate or acetate is added as a source of bicarbonate ions. Slightly hypertonic solutions are usually employed to avoid increasing the water content of the intravascular compartment. A more hypertonic solution containing a higher glucose concentration is used to achieve a more rapid removal of water. In fact, the peritoneal cavity behaves as if it were separated from the body organs by a semipermeable membrane. Warm peritoneal solution (up to 5 L) is perfused into the cavity for 30–90 minutes and then drained out completely. This procedure can then be repeated as often as required. As the procedure requires larger volumes, these fluids are commonly packed in 2.5 L containers. It is not uncommon to add drugs (for instance potassium chloride or heparin) to the fluid prior to use.

Haemodialysis is the process of circulating a patient’s blood through a machine via tubing composed of a semipermeable material such that waste products permeate into the dialysing fluid and the blood then returns to the patient. Haemodialysis solutions need not be sterile but must be free from heavy bacterial contamination.

D)  Inhaler Solutions

In cases of severe asthmatic attacks, bronchodilators and steroids for direct delivery to the lungs may be needed in large doses. This is achieved by direct inhalation via a nebulizer device; this converts a liquid into a mist or fine spray. The drug is diluted in small volumes of Water for Injections before loading into the reservoir of the machine. This vehicle must be sterile and preservative-free and is therefore prepared as a terminally sterilized unit dose in polyethylene nebules.