first shift of preceptorship: told that my IV priming is wrong - page 5

The hospitals in this city use the Alaris pump and this kind of Alaris infusion set: Prior to my preceptorship, I've always twist that end cap a little bit so that the IV solution can dribble... Read More

  1. Visit  IVRUS} profile page
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    If the manufacturer states that they are "single use" item, then using them on anything else is an off-label use and the manufacturer will NOT stand behind it. The ease in which an removed cap can become contaminated is great and therefore, once removed, discard. Best practice ensures better patient outcomes.
    BTW, this is not a SPY message either and therefore, will NOT self destruct after written. :-)
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  3. Visit  samadams8} profile page
    1
    Quote from IVRUS
    If the manufacturer states that they are "single use" item, then using them on anything else is an off-label use and the manufacturer will NOT stand behind it. The ease in which an removed cap can become contaminated is great and therefore, once removed, discard. Best practice ensures better patient outcomes.
    BTW, this is not a SPY message either and therefore, will NOT self destruct after written. :-)

    That's all fine. I am for it. What happens when it doesn't prime well w/ cap on? Again, the goal is to effectively prime the line while also maintaining aseptic technique. If that occurs with the cap still on, great! More more to the manufacturer! Seriously.

    It's just that effectively priming does not always occur this way. So, in such a case, maintain aseptic technique--which is something taught in schools and in clinical practice for a reason. When you are manipulating things that will go into a patient (non-enterally especially), you must THINK and be mindful of what you are doing through the whole process, even when you must troubleshoot.

    In critical care, you must troubleshoot a lot, b/c things do not always work or roll as nicely and neatly as presented in the best case scenarios. Murphy's Law is real often enough. So you have to maintain aseptic technique, while meeting the goals and dealing with Murphy's Law.

    On general principle, I'm cool with the manufacturer's recommendations, especially where they are evidence-based. But we have to be cognizant of what we are doing--the goal and maintaining aseptic technique. A sterile cap cover on a line has a high level of improbability of becoming an off-label court case. LOL


    Nurses must often improvise with materials used. This is nothing new. When you don't have to; fine! Saves time. Who is not down with that? The idea of teaching people certain principles is that if they have to troubleshoot, they are still keeping the core priniciples in mind--i.e., aseptic technique.

    We have primed pressure lines for years and have had to take the end caps off or change them or take them off again to continue priming the presssure lines--even with the little holes in at the end. You just couldn't get enough pressure flow sometimes to get all the air out of the system or around a transducer, etc. If you are careful in what you do, you will not contaminate the inside of the cap. Is there a chance of contamination? Yes! There is always a chance of contamination; hence the importance of teaching people about sterile/aseptic technique.

    This is a common sense kind of thing. If you can prime the thing with the cap on, great. If you can't, loosen it or take it off and be careful. If there is concern about contamination, get a sterile cap or sterile needle and cover the end of the thing to protect it until you are ready to use it for the pt.

    See the point is, I don't really care so long as you are meeting the goals of what you are trying to do--prime the line correctly and maintain sterile technique. This is not advanced theorhetical physics; but it is basic physics when air pockets are not effectively removed for a line.


    OK. It's been fun, but I can't imagine saying any more on this issue. It seems pretty straightforward to me. Troubleshooting is a big part of nursing skills. Things often enough don't work the way they are supposed to. This is why we have brains and are taught certain principles. Oy and vey. Otherwise OP, bite the bullet and get through orientation for God's sake.
    Last edit by samadams8 on Oct 17, '12
    Sugarcoma likes this.


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