Using Exhausted Soda Lime

Re: Using Exhausted Soda Lime

laura dickenson — Sat, 18 May 2013 17:16:01 GMT

Maybe worth mentioning to your boss that the point of having an ADE is so that you can use lower flow rates. By having an exhausted sodalime you are going to have to have a higher flow rate to help negate your ICO2. Higher o2 rates must be more expensive than spherasorb? Also ask him if you are part of the st francis group as we save money with Henry Shein being on this.

Re: Using Exhausted Soda Lime

bongo — Sat, 18 May 2013 14:28:37 GMT

It disheartens me to hear about this but unfortunately I know why its a real predicament for you. You are completely in the right and your patients risk severe hypercapnea by using exhausted soda lime. Really you need capnography to proove this, can you borrow one from a practice?? Or maybe speak to a rep who could supply you with one for a few days. Maybe get advise from an anaesthesia specialist who could give you some links to evidence you can give to your boss. I hope you get this sorted because I think it is pretty unacceptable, good luck!

Re: Using Exhausted Soda Lime

Amy Homer. RVN. NCert A&CC — Fri, 17 May 2013 20:10:16 GMT

what a nightmare for you.

its a tricky situation, but at the end of the day, you are a registered nurse, and its on your head if something happens to the animal whilst under ga. i would refuse to use it. your boss is risking severe hypercapnia for your patients, which is not acceptable. have a look in one of your nursing books at the problems that hypercapnia can cause and maybe take that to your boss

i dont know off the top of my head how much soda lime costs, but its a necessity.

also, maybe sugest that your boss goes on an anaesthesia refresher course! sounds like he hasnt got a clue

hope he sees sens, but if not, stay strong and stand your ground x

Re: Using Exhausted Soda Lime

Juliet Drummond DAVN (med) RVN D32/33 — Fri, 17 May 2013 16:39:32 GMT

Further to Siobhan's statement, sodalime desicates and drys out, even when the canister is not in use, the desication can cause explosions when used with sevo particularly. I empty mine at least once monthly (depending on use) and do not automatically refill it until it is required again. This reduces waste.

Re: Using Exhausted Soda Lime

Siobhan Steven — Fri, 17 May 2013 12:41:03 GMT

The soda lime should be changed after 8 hours of use, just because its not all white or purple (depending on which one you use) doesn't mean its not exhausted, and just to confuse matters it will revert back to its original colour (pink or white) after a few hours, therefore leading you to believe its all good to use agin, and on top of that it gets 'exhausted' from the inside out, so it will be more exhausted than it looks. Your patients will ultimately be experiencing hypercapnia, and respiratory acidosis which is a highly undesirable metabolic condition for your patients to experience. (Its probably best you read up on these conditions so you can discuss the side effects with the veterinarian in question at a respectable level.) Personally I can't understand the aversion to renewing the soda lime, its not a particularly expensive consumable item and the overall side effects are bad.

I hope you can come to an amiable arrangement for the sake of these patients, after all the clients are paying for the procedures, which should cover ALL components used and they have faith that their pets are being given the best possible care, under the circumstances you describe they are not.

Re: Using Exhausted Soda Lime

Sandra Nicoll — Fri, 17 May 2013 11:06:34 GMT

Hi Claire,

Send me an email and I can provide some information depending which inhalant you are using.

Thanks,

Sandra

Re: Using Exhausted Soda Lime

Sal the 1st — Thu, 16 May 2013 23:27:57 GMT

[quote user="claireybeary t"]

i am at the point where i am going to refuse to use it but as a locum, i could well get fired over it. I am sole nurse which is in my favour.

[/quote]

maybe not the answer you are looking for but if you are a locum how about looking around elsewhere for work - getting on the wrong side of a vet is bad news for a locum it tends to stop the work coming in.

Re: Using Exhausted Soda Lime

Nick Shackleton — Thu, 16 May 2013 22:19:37 GMT

Good luck

Re: Using Exhausted Soda Lime

clairebear . — Thu, 16 May 2013 22:00:32 GMT

I have printed a few bits out and emailed someone at Abott too. I will go through it tomorrow, highlight the important bits and give it to the vet tomorrow. Heres hoping i get a new bottle of Monday!

Thanks for your help, its much appreciated x

Re: Using Exhausted Soda Lime

Nick Shackleton — Thu, 16 May 2013 21:57:39 GMT

I would say that you should be. At the end of the day you are accountable for your own actions. Even as a LVN I would be refusing to use it until soda lime has been ordered to replenish the exhausted stuff. At end of the day what's more expensive a bottle soda lime or litigation process........

Re: Using Exhausted Soda Lime

clairebear . — Thu, 16 May 2013 21:36:58 GMT

Also, do you think that, as a RVN i am within my rights to refuse to use the canister?

Re: Using Exhausted Soda Lime

clairebear . — Thu, 16 May 2013 21:20:58 GMT

Thank you! the only non rebreather we have is a mini lack or the humphrey without a canister. I have no SP02/Capnography, the only thing I have apart from (my own) stetheschope is a small oesophageal, only really suitable for cats and small dogs etc but I am forced to use it on every animal as no alternative. I did a dog castrate a few days ago, 12kg dog, on the Humphrey circle, 1.5l O2, 5 minutes in, after maintaining on 2% sevo where everything was stable, heart rate was down to 76bpm, resps normal, colour quite pale, ended up on 1.4%. I confronted the vet, stated that my information had been gathered from the Uni of Liverpool a few years ago when I researched a similar thing. The vet just walked away. Im tearing my hair out!

Re: Using Exhausted Soda Lime

Nick Shackleton — Thu, 16 May 2013 21:14:09 GMT

Basically the soda lime will not be doing its job therefore not absorbing any carbon dioxide therefore you patient will be breathing in this gas, which I don't need to tell you is not good. Do you have capnogrphy?? This would tell you what your patients inspired CO2 levels are, this should be minimal. As an alternative do you have non-rebreathing circuits available that could be used instead??