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Never prefill syringes, even in a dental practice

A recent comment posted under my last blog post “Prefilling and storage considerations for insulin, flu clinics [1],” asked the following question [2]:

I work in a dental practice and the hygienist prefill syringes with chlorhexidine to be used as irrigation following soft tissue management procedures. These syringes are often prefilled and stored 1 – 2 weeks at a time. I am requesting comments on this practice. Thank you.

Best practice is to NEVER prefill any syringes ahead of time. If necessary, you must first check with both the manufacturer of the chlorhexidine and the syringes for compatibility, stability and storage environment (room temp, refrigeration, etc). Many syringe manufacturer’s note that with time some drugs/chemicals could interact with the syringe itself. The chlorhexidine manufacturer will give you guidance as to how long it can be stable in the syringe environment as well.

If acceptable to both manufacturers, then the syringe must be labeled immediately AFTER the product is added to the syringe with the chemical name, date, concentration, date of expiration, and your initials, and stored under the proper conditions. Whoever uses the syringe should validate the above information and check expiration before using.

I like to remind staff that when they use a prefilled syringe that they did not fill and label themselves, they better trust that person because if an error does occur, the person who used the syringe will be blamed for the event—not the person who filled the syringe. Do you trust them that much?

For more on prefilling and storing syringes, click here [3], or go to the Tools page [4] to download a copy of “Infection prevention requirements in ASCs: A Q&A on CMS compliance, common pitfalls, and best practices,” which also addresses regulatory considerations for prefilling syringes.