Administration sets

An administration set is used to administer fluids, blood or medications via an infusion bag into a VAD. The set comprises a number of components. At the top is a spike which is inserted into the infusion container via an entry port. This is covered by a sterile plastic lid which is removed just prior to insertion into the container (Downie et al. 2003). The plastic tubing continues from the spike to a drip chamber which may contain a filter. This is filled by squeezing it when attached to the fluid and waiting for the chamber to fill halfway, thus allowing the practitioner to observe the drops. Along the tubing is a roller clamp which allows the tubing to be incrementally occluded by pinching the tubing as the clamp is tightened; this is used to adjust the rate of flow (Hadaway 2010). It is usually positioned on the upper third of the administration set but should be repositioned along the set at intervals as the tubing can develop a ‘memory’ and not regain its shape, making it difficult to regulate (Hadaway 2010). It is opened to allow the fluid along the tubing to remove the air and then closed until attached to the patient’s VAD. Finally the Luer-Lok end is covered with a plastic cap to maintain sterility until ready to be attached (Downie et al. 2003).

(Royal Marsden 2015)

There is a variety of sets. A solution set is used to administer crystalloid solutions (it can be used as a primary or secondary set and is also available as a Y-set to allow for dual administration of compatible solutions). Parenteral nutrition is also administered via solution sets. Solution sets may have needle-free injection ports which allow for the administration of bolus injections or connection of secondary infusions. Sets may also have back check valves which allow solutions to flow in one direction only and are used especially when a secondary set is used (Hadaway 2010).

Blood and blood products are administered via a blood administration set which has a special filter. Platelets can be administered via blood sets (check with manufacturer) or specialist platelet administration sets. Some medications such as taxanes must be administered via special taxane administration sets as they have a 0.22 micron filter.

(Royal Marsden 2015)