Printable PDF: Fluid Bag Use and Storage SOP

Purpose/ Applicability: 

To provide clear guidelines for the warming, storage, and use of sterile fluid bags for parenteral or external administration, to maintain sterility and product integrity.

Scope:                            

This SOP applies to all sterile fluid bags used for parenteral or external use, including but not limited to Sodium Chloride 0.9%, Lactated Ringer’s Solution, Normosol-R, Plasma-Lyte, Mannitol 20% and Hypertonic Saline 7.2%.

Certain products have special handling or warming restrictions, which are outlined in the Important Exceptions section of this SOP.

General Safety Requirement:

• All sterile fluid bags and bottles must be inspected for clarity, intact seals, and absence of visible contamination before each use.
• Any container showing cloudiness, particulates, discoloration, leakage, or other signs of compromise must be discarded immediately, regardless of the product type, storage conditions, or allowable use period.
• AAHA Accreditation Requirement (John A. Coyne South Clinic):
  A new container of fluids and a new administration set must be used for each patient, regardless of the route of administration, in compliance with AAHA Standards.

Procedure:

Labeling Requirements

To ensure accurate tracking of discard times and avoid relying solely on manufacturer expiration dates:

• All fluid bags/bottles must be labeled with the date and time when:
• Removed from protective overwrap (opened)
• Placed into a fluid warmer

1. Fluid Solutions (bag or bottle) – OPENED

 Room Temp/Refrigerated

• • Opened fluid bags (i.e., removed from the protective overwrap) may be stored for up to 24 hours at room temperature or under refrigeration.
  • External use only (e.g., wound irrigation):
    • With a line attached, may be used for up to 30 days or until the expiration date, whichever comes first.
    • Without a line, withdrawn via a syringe/needle, may be used for up to 7 days.
    • Must be clearly labeled: “For External Use Only”

Warmed Fluids – OPENED (Removed from Warmer)

• • Opened fluid bags removed from the warmer and stored at room temperature must be used within 24 hours.
    • Best practice: Discard at the end of the business day.

2. Important Exceptions

• • Dextrose-containing solutions and Hetastarch: Do not warm under any circumstances.
  • Mannitol 20% (VetOne, 100ml vial):
    • If crystals form, warm in hot water or autoclave for 15 minutes.
    • Storage recommended at 15°C - 30°C.
  • Hypertonic Saline 7.2% PF (VetOne, 1L bottle):
    • Not recommended for long-term storage in a fluid warmer.
    • If necessary, the fluid warmer must be set to ~37°C; do not exceed 40°C.
  • In all cases, the bag or bottle must be maintained in aseptic conditions and remain visibly uncontaminated.

3. Fluid Solutions (bag or bottle) – UNOPENED

• • Warmed unopened solutions may not be rewarmed or returned to regular room temperature storage beyond 24 hours.

Definition(s):

Aseptic Technique: A method used to prevent contamination by pathogens during the handling or preparation of sterile products.

External Use: Use of fluids for non-parenteral purposes (e.g., wound flushing or lavage), not intended for injection.

Opened Bag: A fluid bag from which the protective overwrap has been removed or has been accessed via spike, needle, or other port.

Parenteral Use: Administration of fluids via injection routes (e.g., intravenous, subcutaneous).

Unopened Bag: A fluid bag that remains sealed in its original protective overwrap and has not been accessed.

Warmed Fluids: Sterile fluid bags or bottles that have been placed in an approved fluid warmer to increase temperature before administration