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Intrafix® SafeSet Flush
Total prescribed dose delivery
Intrafix® SafeSet Flush combines a Caresite® needlefree injection port with AirStop technology, allowing post-medication flushing via a syringe. This ensures complete delivery of the prescribed medication, minimising the risk of underdosing.
Underdosing
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Due to residual volume in the administration set line, up to
0%
of the active prescribed drug may not be administered1
Intrafix® SafeSet Flush
Intrafix® SafeSet Flush combines a Caresite® needlefree injection port above the drip chamber with AirStop technology at the base of the drip chamber. The combination enables the administration set line to be flushed post-medication via attachment of a small volume syringe to the Caresite® needlefree injection port. This permits the residual volume of prescribed antibiotic only to be administered to the patient, reducing the risk of air embolism and fluid overload which could occur if using a flushing bag.
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Flushing residual volume
Access the Caresite® needlefree valve using a small volume syringe, enabling the residual volume of the drug to be infused without the risk of overloading the patient with fluid.
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AirStop
AirStop technology helps prevent air entering the line enabling flushing of the residual volume of the drug.
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Waste reduction
Flushing the line helps avoid unnecessary antibiotic waste and minimises environmental exposure from discarded administration sets containing residual medication.
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Line flushing guidance
In 2021, the National Infusion and Vascular Access Society issued line flushing guidance highlighting that administration methods must be improved to minimise the risk of underdosing and to....
"Ensure that all of the prescribed medicine is administered"5
Line flushing guidanceHow does underdosing occur?
Short-term intermittent infusions, such as antibiotics, are commonly administered using gravity or infusion pump systems. In gravity sets, once the infusion container is empty, air is drawn into the line until equilibrium is reached between the line’s fluid level and the venous back pressure. This leaves a residual volume of antibiotic trapped within the tubing. Similarly, when using infusion pumps, the line remains filled with antibiotic, even after the programmed volume has been delivered.
It’s a common misconception that flushing only the short extension line (needlefree connector) post-infusion adequately clears the medication. In reality, a significant amount of antibiotic remains in the administration set itself—often overlooked—which can lead to underdelivery of the prescribed dose by as much as 20% for a 100 ml infusion and up to 40% for a 50 ml infusion.
What are the implications of underdosing?
Resistance is a natural biological phenomenon, but misuse of antibiotics is accelerating the process. For example, the under delivery of antibiotics reduces the likelihood of delivering the expected therapeutic effect resulting in subtherapeutic levels, which could be a significant contributor to the development of resistance strains3
Under delivery is accumulative, with a study from one NHS Teaching Hospital highlighting that a patient on an antibiotic regime prescribed for 12 weeks, was under delivered 16 ml with each infusion, resulting in an accumulative effect of 12 missed doses12
The accumulative effect of under delivering IV anibiotics could delay the swith to oral, increasing the patient's length of stay, spend on medication and consumable waste.
Clinical Support
Clinical Specialist Team
The B. Braun team work in partnership with you to provide continuous support and education throughout the life of the products you purchase from us. When you choose to introduce Intrafix® SafeSet Flush into your organisation, our dedicated team of Clinical Therapy Specialists will provide you with complimentary ongoing clinical education support.
Find out moreClinical demonstration videos
Intrafix® SafeSet Flush - Gravity Administration Set for General Ward Use Facilitating a Post Medication Line Flush
Infusomat® SafeSet Flush - Volumetric Pump Administration Set for General Ward Use Facilitating a Post Medication Line Flush
Infusomat® SafeSet Flush - Volumetric Pump Administration Set for ITU/CC Facilitating a Post Medication Line Flush
Scientific evidence & webinars
Research and guidance
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Antibiotic underdosing and disposal in NHS organisations across Great Britain
Research Report & Policy Brief
pdf, 1.5 MB
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Antimicrobial Stewardship & Patient Safety Improvements
Clare Goodyear – Salisbury NHS Foundation Trust
pdf, 615.2 KB
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Antimicrobial Stewardship in OPAT
Laura Maclachlan – Hull University Teaching Hospitals NHS Trust
pdf, 842.3 KB
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Non-flushing of IV administration sets: an under-recognised under-dosing risk.
Dawn Michelle Cooper, Thomas Rassam, Adrian Mellor
link
Symposia
Under Delivery of IV Antibiotics Workshop
Phil Hazeldine, ED Nurse, B. Braun Ltd. & Claire Davies, Paediatric Nurse, B. Braun Ltd.
Advancements in IV Administration: The Issue of Underdosing
Mark Santillo – Former Chair of the NHS Pharmaceutical Quality Assurance Committee
Implementing IV Line Flushing Guidance in Critical Care
Kate Holland – Royal Bournemouth Hospital
Line Flushing – Changing the way we do things
Andrew Barton – Frimley Health NHS Foundation Trust
Intrafix® SafeSet Flush Sample Request
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1. Santillo, M (2022) IV Forum; Advancements in IV Administration,
https://www.youtube.com/watch?v=0WAupmxRDTY
2. Cooper DM, Rassam T, Mellor A. Non-flushing of IV administration sets: an under-recognised under-dosing risk. Br J Nurs. 2018 Jul 26;27(14):S4-S12. doi: 10.12968/bjon.2018.27.14.S4. PMID: 30048183.
3. Harding M, Stefka S, Bailey M, Morgan D, Anderson A. Best Practice for Delivering Small-Volume Intermittent Intravenous Infusions. J Infus Nurs. 2020 Jan/Feb;43(1):47-52. doi: 10.1097/NAN.0000000000000355. PMID: 31876774.
4. Roseau JB, Pradines B, Paleiron N, Vedy S, Madamet M, Simon F, Javelle E. Failure of dihydroartemisinin plus piperaquine treatment of falciparum malaria by under-dosing in an overweight patient. Malar J. 2016 Sep 20;15:479. doi: 10.1186/s12936-016-1535-8. PMID: 27646822; PMCID: PMC5028982.
5. National Infusion & Vascular Access Society, Intravenous Administration of Medicines to Adults: Guidance on ‘Line Flushing’, version 3, 2021
6. Barton, A (2022) Line Flushing – Changing the way we do things, presented at Infection Prevention Society IV Forum Conference, https://www.youtube.com/watch?v=eEOeYVjru00
7. Goodyear, C (2022) Poster presentation at the National Infusion and Vascular Access Society Conference, Antimicrobial Stewardship & Patient Safety Improvements: Introducing the NIVAS Line Flushing Guidance