Remove the protective cover on the IV tubing spike. Be careful and do not contaminate the spike. Remove protective cover from spike on IV tubing. Without contaminating the solution port, carefully insert the IV tubing spike into the port, gently pushing and twisting.
Insert IV spike into sterile solution using sterile technique. The IV bag should be approximately one metre above the IV insertion site. Fill the drip chamber one-third to one-half full by gently squeezing the chamber. Remove protective cover on the end of the tubing and keep sterile. Filling the drip chamber prevents air from entering the IV tubing. Fill drip chamber. With distal end of tubing over a basin or sink, slowly open roller clamp to prime the IV tubing.
Invert backcheck valve and ports as the fluid passes through the tubing. Tap gently to remove air and to fill with fluid.
Inverting and tapping the access ports and backcheck valve helps displace and remove air when priming the IV tubing. Invert IV tubing when priming with solution.
Once IV tubing is primed, check the entire length of tubing to ensure no air bubbles are present. This step confirms that air is out of the IV tubing. Close roller clamp. Cover end with sterile dead-ender or sterile protective cover. Hang tubing on IV pole to prevent from touching the ground. Keep the distal end sterile prior to connecting IV to patient.
Label tubing and IV bag with date, time, and initials. Label IV solution bag as per agency policy. Do not write directly on the IV bag. Labelled IV bag. This reduces the transmission of microorganisms. Hand hygiene with ABHR. Verify and select correct IV solution bag and compare to the medication administration record MAR or physician orders. Introduce yourself, identify patient, and explain procedure. Proper identification of a patient prevents medication errors.
Explaining the procedure provides an opportunity for the patient to ask questions. Hand hygiene prevents the transmission of microorganisms. Remove outer plastic packaging and squeeze bag to test for leaks and expiration date. I definitely agree that this can not be good practice nor standard practice.
Thanks for your response Lynn. I may be calling you back to Hospira Lynn for another meeting of the minds. What does your calendar look like for the next couple of months? James C. The calendar is totally packed until after the AVA conference in late Sept, but we could arrange something after that.
My email is [email protected]. Thanks, Lynn. I always set my primary bag at less than the total amount such as for 1 liter, for ml. I have fount over the years that bags are usually short rather than over. I was told, after the fact by someone else, "not to worry" when the infusion pump alarm goes off, it doesn't need to be handled right away.
But they did not explain the mechanics of any of the IV process with regards to avoiding the introduction of air, as they were not a Nurse or Doctor. I would feel slightly better if I knew the mechanics of it for the next time something occurs. Join Early-Retirment. The IV catheter has a needle inside of it that is used to puncture the skin and enter the vein, then the needle is removed leaving the catheter in the vein.
These are flushed usually with normal saline prior to insertion, along with the small connecting tubing that goes to the IV solution. If the IV solution infuses completely, usually the solution in the tubing stays put creating a closed system so no air enters.
I have seen some blood from the vein back up into the tubing a very short distance You really don't ever want an IV solution to run dry because the biggest concern is the IV clotting off and needing to start another IV. In over 35 years of nursing I have never seen any amount of air that would cause any concern enter a patient from a peripheral IV.
Central lines or arterial lines are a different story, and are treated very carefully to ensure that the infused solution never runs out, and that air is never introduced. For some, the glass is half empty. Blood normally contains dissolved gases. The small amount of air introduced by IVs and flushing quickly goes into solution. Embolism occurs when gases come out of solution within the blood system in the body. Edit: Blood pressure is higher than atmospheric pressure. In order for fluids to be introduced via an IV then the fluid pressure at the IV entry into your arm must be greater than 32 inches of water column greater than you lower blood pressure number.
This increased pressure is usually achieved by hanging the IV bag higher than your body. Many of the IV "pump"s are more of a metering device to control the flow rate into your body than to increase the IV fluid pressure. When the IV bag runs dry, the IV fluid pressure water column height in the bag and tubing drops until no more flow into your body is possible.
The metering pumps generally don't create enough pressure to pump air into your body. If you knock over the IV bag pole or drop the bag on the floor, you will quickly see blood being pushed out of your body into the IV tubing, so avoid doing that.
Chaucer, W. Shakespeare All that is gold does not glitter. I'm learning a lot here! After all these years, I never had an IV in me, until Silver - Thank you very much for the run-through!
I had wrongly assumed that a hollow needle was used, and that it stayed in the patient, with a stub of tubing connected to the needle. Sort of like a hypodermic needle with tubing attached to it. Then I hung the new bag, re-primed the line, rehooked, unclamped, flushed again then restarted the drip and that seemed to work fine.
Jun 4, Even though the bag ran dry, the tubing does not. If you look closely, you will see that a small amount of fluid remains in the tubing, thus, no air gets into the patient. Just make sure that you re-prime the tubing before connecting a new bag using the same tubing.
Oh good thanks, I was afraid this was a stupid question but as a new grad I am always terrified I am going to do something wrong and hurt the pt. Has 40 years experience. Did I understand correctly? You had air in the IV tubing all the way to the needle hub? That doesn't always happen because the back pressure of the blood in the patient's vein will reach an equal pressure with the air so things are just stalled and blood usually backs up into the IV tubing. Atmospheric pressure will automatically pull the air out through the end of the needle along with the new IV fluid.
Have a towel ready to catch any IV fluid because it comes down and shoots out through that open access needle very fast. With a 10cc syringe or larger gently attempt to get a flush of blood back into the tubing. If that fails I would try to very, very gently attempt to flush the IV line with some saline.
If you feel any kind of pressure do not continue to push because you will push any blood clot from the cannula into the vein. Your IV is lost and will need to be restarted. However, if you are able to flush the line I would use a 20 or 30cc syringe of saline and give the line a nice, slow continuous flush to clear it and make it patent.
In the days before we were allowed to put all IVs on pumps or drop counters we all used to carry a few needles in our pockets for these occurrences. Also, when you are running IVs by gravity you really need to check them--at least once an hour. With gravity drips I always found that no matter how accurately I first set the drip rate I always found it running faster when I went back to check it.
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