Check solution against physician order
Check order for fluid, Check volume of fluid
Check expiration date for fluid; Check that packaging is intact for fluid
The primary infusion we used in skills class was 1000mL of normal saline.
I will use primary set of tubing, ensure package is intact and that I am using the correct tubing for the
type of infusion/fluid. Clamp the tubing- downward position
I WILL SPIKE THE solution Bag before tubing is connected into patients IV port, Connecting tubing to bag
(not hanging), do it over trash can
Spike IV Solution bag by holding it steady, then insert spike by using firm pushing and twisting motion on
90 degree angle till whole thing goes in to entry port, of the taller knob on solution bag
Hang IV solution bag onto IV pole, bc it works by gravity.
Then prime the line(clamp should still be closed)
Then I will Squeeze drip chamber to create a vacuum, about ½ way full with solution
Gently roll up clamp to release and let the line open so I can see the fluid move through tubing
Finish priming and push air out totally out of tubing. Making sure there are no air bubbles, if so, I would
keep priming until I see drops come out of male connecter.
Next I will turn on the pump:
Program as a new patient (name , dob, mrn), calc I & Os.
Open channel of pump to load tubing, insert by stretching the tubing., close channel of pump
-select channel to work with (ex: IV fluid of normal saline .9%); determine rate/ vol(ex: 100ml per hr)
Also program for 900ml volume so it will alarm when bag is almost empty
-connect tube to patient
make sure existing IV site is not infiltrated or infected
Then scrub the access cap for 30 seconds on IV attached to patient with alc wipe
-
Push firmly to connect eachother into ports
Secure the iv tubing with tape as needed
Flush line with 10 cc of normal saline. syringe is sterile already. Get rid of air bubbles by tapping
Flush the line, pulsation-, pull back to see if there’s blood return
Then hit start on pump machine and that it!
Disconnecting:
Clamp patient port to cut off line, cap tubing side and patient said
Piggyback:
Main fluid was saline but dr ordered an antibiotic
--gather secondary set of tubing (has hook to hang the primary, saline a little lower on pole)
-whatever is higher will admin first, so we want the secondary med to be up higher.
The secondary bag is usually 50-250 ml
I will clamp tubing first, spike the secondary bag and twist in using firm motion.
Then I will prime the line again
-
Bag should be up on pole
Create a vacuum in chamber by squeezing to fill half way with solution
Connect piggyback tubing to the access port above pump
-scrub port with alc wipe prior to connect
Place label on tubing with date
Program secondary med in pump by selecting secondary infusion to OVERRISE
Input the rate, channel to work with, and medication
Hit start, the primary solution is cut off until the antibiotic is fully completed infusion
Time tape:
Place time tape on solution bag with time when stared , time when checked(make sure its infusion at
appropriate rate), before leaving, mark the amount left in bag
IV site is labeled with time, date, location, initials, size of catheter
Tubing is labeled bc it must be changed every 72 hours
-
Write date and time of placement and date it should be changed
Disconnecting an IV:
I will need Small guae and tape and to be wearing gloves
-pre tape gauze
-remove transparent dressing
Apply pressure when putting gauxe on to remove IV out of patient
Assess the site
-document: date. Time. Why removed
Flow rates:
To calculate pump rate (ml p hr
Total infusion volume divided by total infusion time
Ex0 500ml to be infused over 5 hour period
The pump rate would be 100ml p hr
To calc gravity rate(drops per min)
Total infusion time multiplied by drop factor divided by total time of infused mins