Pre-filled saline syringes more effective over manually prepared syringes
Parenteral drug administration involves administering drugs through routes other than the digestive tract via injection or infusion. The common parenteral routes include intravenous (in the vein), intramuscular (in the muscle), intradermal (through the skin), subcutaneous (under the skin), and intraperitoneal (into the peritoneum that houses the abdominal organs).
Most hospitalized patients receive parenteral drugs during their hospital stay. It is one of the most commonly used methods to produce a quick onset of drug action and 100% bioavailability.1 However, parenteral drug delivery has some drawbacks: lack of – safety, convenience, affordability, sterility, etc. Such flaws with this delivery system may make it a less preferred choice.
Pre-filled saline syringes: an effective solution
Most innovative products like monoclonal antibodies, proteins, and peptides administered via the parenteral route require accurate dosing and safe handling. Pre-filled saline syringes are fast becoming a popular choice of drug delivery in healthcare settings. Pre-filled syringe cartridges are designed to fit into specialized syringes, which are used to administer various fluid medications.
Some definite advantages of pre-filled saline syringes include:1,2
- Convenience:In cases of emergency, pre-filled syringes can save time, offer quick drug administration, thereby avoiding overcrowding in hospitals
- Accuracy: Pre-filled syringes assure accurate measurement of dosing
- Safety: Use of pre-filled syringes allow injection of medication without having to push manually, so it reaches appropriate depth and offers smooth administration
- Affordability: Pre-filled syringes are much less prone to crack or break compared to standard ones; thus, reducing the manufacturing costs
- Sterility: Pre-filled syringeshave a better shelf life (2 to 3 years) as opposed to standard syringes (optimal effectivity for approx. 12 hours)
- Low risk of contamination: Use of pre-filled syringes eliminates the likelihood of cross-infection arising from needle reuse
With their pre-measured dosage, pre-filled syringes may help reduce dosing errors and increase patient compliance. In addition, pre-filled syringes help reduce the risk of accidental needlestick injuries and exposure to toxic products while drawing medication from vials, thereby offering greater patient safety.3,4 Pre-filled syringes require less overfill, unlike vials that need 20-30% overfill and contribute to potential waste in manufacturing.
The latest Infusion Therapy Standards of Practice 2021 recommend using pre-filled saline syringes to reduce the risk of catheter-related bloodstream infections (CRBSI) and prevent syringe-induced blood reflux.
Research indicates that the risk for breaking the aseptic non-touch technique is greater with the manually prepared syringes than pre-filled syringes (72.3% vs. 4.9%).5 Pre-filled syringes can reduce the risk of central line-associated bloodstream infections (CLABSIs) and improve patient outcomes.
An international study conducted to evaluate the clinical effect of pre-filled saline syringes and their impact on healthcare workers, indicated that pre-filled saline syringes significantly reduced catheter-related bloodstream infections (CRBSIs) and catheter blockage (77% and 62%, respectively). The study also reported increased catheter retention time and a 79% reduction in needlestick injuries (NSIs).6
According to the latest Infusion Therapy Standards of Practice 2021, it is critical to flush vascular access devices before each infusion to assess catheter function and reduce catheter-related complications.7 Flushing time is shorter with pre-filled syringes than manually prepared ones, which may decrease the nurses’ workload and help increase the quality of care in intensive care units. Pre-filled saline syringes may also help reduce central line-associated bloodstream infections and improve the quality of care, thereby safeguarding hospital and healthcare workers’ reputation.
Appropriate use of VADs is critical in providing patient safety and infection control. Thus, it is recommended that hospital staff use effective and innovative devices like pre-filled saline syringes to improve patients’ hospital experience and staff satisfaction. The latest practice guidelines also advocate the usage of pre-filled syringes for flushing VADs.
Dr. Roopa S Bhandary
M.B.B.S, M.D. Microbiology
Assistant professor in Department of Microbiology,
A.J Institute of Medical Sciences and Research Centre.
- Makwana S, Basu B, Makasana Y, Dharamsi A. Prefilled syringes: An innovation in parenteral packaging. Int J Pharm Investig. 2011;1(4):200-206. doi:10.4103/2230-973X.93004
- Glenn AT. Prefillable syringes: Trends and growth strategies. Cedar cottage, Newtimber Place Lane, West Sussex, BN6 9BU, United Kingdom: ON drug delivery Ltd; 2006. Registered in England: No 05314696.
- Shawn DK. Cedar cottage, Newtimber Place Lane, West Sussex: United Kingdom: ON drug delivery Ltd; 2007. [Last Cited on 2007 Oct 10]. A better fill for prefilled syringes: Applications and advantages of bubble free filling for today’s parenteral products; pp. 17–22. Available from: http://www.ondrugdelivery.com .
- Karras L, Wright L, Cox L, Kouns T, Abram, Akers MJ. Current Issues in Manufacturing and Control of Sterile Prefilled Syringes. Pharm Tech. 2000;24:188.
- Ceylan G, Topal S, Turgut N, et al. Assessment of potential differences between pre-filled and manually prepared syringe use during vascular access device management in a pediatric intensive care unit [published online ahead of print, 2021 May 13]. J Vasc Access. 2021;11297298211015500. doi:10.1177/11297298211015500
- Lei T, Ting Z, Aixia M, Qiang L. Meta-analysis on the clinical effectiveness of prefilled saline syringes. School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, China ///Chinese Nursing Management. 2017;17(11):1545-1555.
- Infusion Nurses Society. Infusion Nursing Standards Practice. J Infus Nurs. 2021