Taurolock®

Paediatric guidelines (in development)
NHS Lothian

All patients on cycling PN for 20hrs or less should commence Taurolock
Taurolock is contraindicated in patients allergic to Taurolidine and/or citrate

 

Requirements

  1. TROLLEY
  2. STERILE DRAPE
  3. PAIR OF NON STERILE GLOVES (appropriate size)
  4. 5mL AMPOULE SODIUM CHLORIDE 0.9% FOR INJECTION
  5. AMPOULE OF TAUROLOCK®
  6. 10mL LEUR LOCK SYRINGES x 2
  7. FILTER NEEDLE 19G x 2
  8. SYRINGE CAP
  9. SODIUM CHLORIDE 0.9% LABEL
  10. ALCOHOL 70% & CHLORHEXIDINE 2% WIPES
  11. ALCOHOL HAND RUB

Administration Taurolock® procedure

DO NOT TOUCH KEY PARTS - DISCARD IF CONTAMINATED

  1. Wash and dry hands
  2. Clean tray inside and out with an alcohol 70% & chlorhexidine 2% wipe and allow to dry
  3. Put on apron
  4. Apply alcohol hand rub and allow to dry for 30 seconds
  5. Put on non sterile gloves
  6. Attach green needle to one syringe and filter needle to another syringe
  7. Check sodium chloride 0.9% and Taurolock® ampoules (with a registered nurse)
  8. Using syringe with green needle draw up the 5mL of sodium chloride 0.9%
  9. Remove green needle from the syringe and dispose of in sharps bin and
    then remove any air present from the syringe attach syringe cap. Affix sodium chloride 0.9% label to syringe
  10. Using syringe with filter needle draw up 1mL of Taurolock®
  11. Remove the filter needle from the syringe and dispose of in sharps bin and then remove any air present from the syringe, attach syringe cap. Affix Taurolock® label
  12. Clamp intravenous catheter and disconnect the giving set from the Smartsite®
  13. Clean the Smartsite® on the intravenous catheter with an alcohol 70% & chlorhexidine 2% wipe and allow to dry for 30 seconds
  14. Connect syringe containing the sodium chloride 0.9% to the Smartsite® and turn ¼ of a circle
  15. Check the line for flashback of blood
  16. Slowly inject the sodium chloride using a pulsing action.IF RESISTANCE IS PRESENT, YOU MUST CONTACT MEDICAL STAFF AND
    GET FURTHER INSTRUCTIONS    DO NOT USE EXCESSIVE FORCE AS THIS MAY DAMAGE THE CATHETER. DO NOT USE ANY LESS THAN A 10mL SYRINGE TO CHECK PATENCY OF LINE
  17. Holding the syringe, remove it from the Smartsite® and discard directly into sharps bin
  18. Connect syringe containing Taurolock® to the Smartsite® and turn ¼ of a circle.
  19. Slowly inject the Taurolock®. Do not inject the full amount too quickly. Continue to inject the last 0.5mL whilst closing the clamp at the same time. In this way you keep a positive pressure in the catheter and prevent backflow of bloodIF RESISTANCE IS PRESENT, YOU MUST CONTACT MEDICAL STAFF AND
    GET FURTHER INSTRUCTIONS    DO NOT USE EXCESSIVE FORCE AS THIS MAY DAMAGE THE CATHETER
  20. Holding the syringe, remove it from the Smartsite® and dispose of in the sharps bin
  21. Tape the catheter to the chest with the injection site in the upright position or place in a protective pocket, above the level of the heart to prevent flashback of blood

According to manufacturer’s advice Taurolock® should be aspirated from the line prior to commencing an infusion. This is due to a low clinical risk of transient hypocalcaemia due to citrate infusion. Acknowledging the difficulties with aspiration of some lines, the inability to accurately determine dead space and the risk of sepsis it has been agreed that Taurolock® can safely be slowly flushed into the patient prior to commencing the PN infusion.

Taurolock can be concomitantly used during treatment with systemic antibiotics, however often this is not practical and therefore it can be withheld until the antibiotic course is completed