Evaluation of a Double-Enclosure Double-Vacuum Unit Scavenging System for Ribavirin Administration

BACKGROUND: Because of our concern for the safety of bedside caregivers who care for infants receiving ribavirin for long periods of time each day for many days, we evaluated the effectiveness of a double-tent enclosure with vacuum scavengers during simulated and actual patient administration. MATERIALS & METHODS: Part 1—We sought to determine whether two or three scavenging pumps were necessary, by 3 8-h trials with 2 pumps and 3 8-h trials with 3 pumps. Entry into and replacement of mannequin occurred according to protocol. Continuous samples were obtained from three locations in the room. Part 2—The double-tent, double-pump scavenger system was evaluated with patient simulation for a 16-h period. Part 3—The double-tent, double-pump system was evaluated during actual patient use. Air samples were also collected during ribavirin administration via mechanical ventilator circuit with filters in the expiratory limb. Coded environmental samples were analyzed by liquid chromatography. RESULTS: Environmental levels were effectively decreased below published maximal acceptable levels. CONCLUSIONS: Use of a double-enclosure, double-pump scavenging system and implementation of entry protocols ensure reduction of environmental ribavirin levels below recommended maximum levels during administration to spontaneously breathing patients. Use of expiratory filters adequately controls environmental ribavirin levels during mechanical ventilation .