I just moved from one level I trauma center to another in a different state. Of course I expected a lot of things to be done differently, but I think my new hospital may be setting up arterial lines incorrectly.
At my old hospital, we would place the NS bag into the pressure bag, invert it, and pressurize it so that all the air was pushed out of the bag AND the chamber. At my new hospital, they seem to simply prime the NS bag just as they would for a regular PIV infusion, meaning they leave air in the chamber and don't get all the air out of the bag. I was told by someone that they do it this way so that they can tell if it's dripping... but you don't NEED to tell if an arterial line is dripping. If it's working correctly, then you'll see it flush the line.
Am I wrong about this? It concerns me because in one trauma I was working, the arterial line chamber actually emptied somehow, which put the pt at big risk for an embolus if someone flushed the line.
I'm new here and don't want to make waves, but I think a policy change might be needed. What do you guys think?
Jul 4, '11
by Esme12, ASN, BSN, RN Senior Moderator
I have moved from one part of the country to another. There are HUGE variances as to procedures on how to do things properly.....what is correct at one facility is forbidden at another and in true nurse form the nurse who doesn't do it "Our way"
is somehow lacking, uneducated, or inexperienced. So just becasue it is different doesn't mean it isn't safe.
I have done it both ways depending on department and facility preference. In CTPACU or cath lab we always removed ALL the air to prevent possible "air embolisim". In neuro ICU or MICU not so much. In Pedi all air was meticulously removed from everything including IV lines.
You need to check with your educator to see what the policy is......the staff my not know where it is but if Joint Commision comes through trust me they have a policy. When I moved from the midwest to the east coast there were MANY MANY things that were different here than back home........but were equally effective and safe.
Something as simple as a patient gown got me one of my biggest reprimands.
I was in the trauma room with some other nurses being shown post mortem care (we didn't do post mortem care where I came from....they stayed in the room after they were bathed,with a sheet over the head until the funeral home or coroner came we assured there were ID bands on the patient and belongings but no tying no toe tags). One of the nurses told me to get a Johnnie. I asked "A Johnnie?" and the nurse replied "A Johnnie....you do know what a Johnnie is don't you?
" I mean you did come with experience didn't you????"
I thought "Ok...a Johnnie" where I come from the male penis is a Johnson and the bathroom is a John........so......even though I thought it was crazy I brought in A BEDSIDE COMMODE!
What they could possibly want a bedside commode for a dead person was beyond me but I'm a team player sooooooooo........
Needless to say it wasn't well recieved and even got me pulled in the office to question my abilities......true story
. One I never quite lived down either
Moral of the story being there are many way to do something that are safe and correct right down as to how to dress the A-line or secure the PA line that are unique to each facility. Be careful of sacrificing all the sacred cows in your first few weeks of employment. YOU may not be familiar with how they do it but it doesn't make it unsafe....go straight to the educator or manager and ask them for the policies.....they're there......good luck.
Last edit by Esme12 on Jul 4, '11