Forgetting to prime peripheral IV line...

Specialties Emergency

Published

Hi All! I have been dealing with this in my head all night!! I've searched the internet, but would like your input. If you forget to prime a peripheral IV line that infuse by gravity on a child, what would happen? Severe coughing? Would the child be ok? Any insight will be greatly appreciated.

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Specializes in Pediatrics, Emergency, Trauma.

I need clarification.

Are you talking about not flushing a primary IV line, or not priming tubing?

It is imperative to assess the IV site before giving any fluids to assess patency and to prevent complications.

I have to say I have not "primed" an IV site, meaning maintained an site without having normal saline flush in the connecting IV line for the peripheral site; maybe you can clarify and/or others can respond to your question.

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I never infuse by gravity on pediatric patients. Always a pump or at least a Buretrol/Dial-A-Flo device.

Other than that, I agree with the above poster- your question is unclear. Can you clarify?

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The iv tubing itself was not primed. It was normal saline that needed to be infused. Careless mistake. Too complacent. I just reread my post. I see how that could be unclear. Did this clarify?

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Specializes in PICU.

Peds ICU nurse is slightly freaking out about that question. There has been no research about what about of air could be harmful to a Peds pt. in a "heathy" kid it might be ok. In a kid w a PFO, deadly.

Air emboi are no joke. I've taken care of a gentleman who received one to the brain. Devastated.

The other night my ECMO circuit nearly shut down bc of a tiny amount of air from a flush in a cvl.

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There was coughing for a few mins. Then he seemed ok. So, should the child be in the clear? I had to leave before he was discharged, but when I left he was ok. just want some peace of mind.

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Thank you GrapeRN!

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Specializes in 15 years in ICU, 22 years in PACU.

Very interesting article.

12ml of air in 2/3 IV tubing plus extension set. That's more than I would have guessed. I'll have to look that up now.

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This begs the question, what was the volume of the tubing that you used? Every package of tubing states the end to end volume of the tubing. In adults, primary alaris pump tubing has a volume of ~25-30mL.

If you had run whatever you were running on a pump that would have avoided the problem because the pump would have alerted you to air in the line.

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Specializes in ER, ICU.

I can't say this was harmless, there is too little information. But I hope you are horrified, not just mildly curious. Every patient is different so I don't think you will find any literature on the amount of air that will cause harm. Ethically this should have been reported the minute it was realized. That way the physician could have decided what evaluations might be needed.

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Specializes in Trauma Surgical ICU.

Wow, sorry I don't work peds but i thought everything was on a pump for kidos. OP I hope you are more careful in the future and I hope u notified someone!!

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