What did I do? Blood in IV tubing!

[Hockeynursing]

Hi there,

I am looking for reassurance and guidance.

i had a patient today who had an IV infusing on a pump. The IV ran dry and needed a new bag so the pump was beeping.

i thought I knew what to do so I grabbed a 10 cc syringe and attached it to lowest port, clamped at patients side to ensure I wouldn't draw his blood. I had huge resistance when pulling (I realize now this was because I hadn't changed he bag yet so was pulling from an empty bag)

what happens next requires explanation..

at that point, I let go and immediately blood started climbing the line a foot up tubing.

i disconnected tubing, flushed IV and primed and attached new tubing.

did this happen because pressure was more in his vein? Because I took air out of bag?

any harm to patient? He seems totally fine!

next time I will disconnect and run it through! Or attach new bag first!

thanks so much I am very worried. I fear air got into him some how but I don't know how that would have happened

[BSN16]

Blood was just back flowing into the iv. However I do encourage you to ask another more experienced nurse in a "I don't know" situation. Better safe than sorry

[RescueNinjaKy]

It was probably just some blood back flowing. It happens a lot with high blood pressure people and very slow infusion rate, or in your case not infusing. Next time don't set the pump to infuse the whole volume. If I have a 500ml bag I set it to infuse 400 so when I have 100 left it beeps and I can set it to infuse the remaining 100 while I prepare a new bag.

[BSN16]

Also if your iv happens to run dry and you don't want to replace the tubbing you were correct. However you add the new bag first before attempting to remove the air... Then start the infusion

[Hockeynursing]

Thank you for responses, I have definitely learned and done quite a bit of research now to ensure the same mistake doesn't happen. I'm glad to know no harm will come to patient.

[KRVRN, BSN, RN]

Pulling back on the 10cc syringe probably created negative pressure inside the line. Then it equalized by pulling the pt's blood back.

[Hockeynursing]

And do you think there would

be any harm from

this?

[NurseOnAMotorcycle, ASN, RN]

What? The blood in the line just means the IV is in the vein where it's supposed to be. There is absolutely nothing wrong with the line or the patient.

[Scrubs_n_sirens, MSN, RN]

You're fine. Blood back flow happens. You probably made a vacuum when you tried to flush the line. (:

[guest769224]

RescueNinjaKy said:

It happens a lot with high blood pressure people and very slow infusion rate

Venous blood pressure has that much exertion, to travel a foot up a tubing set?

[NotAllWhoWandeRN, ASN, RN]

ICUman said:

Venous blood pressure has that much exertion, to travel a foot up a tubing set?

When you create negative pressure by pulling back on a locked line then opening the line at the patient end, yes, it makes sense to me.

Some of the IV systems I've worked with clamp once you install them into the pump to prevent flow to gravity and you have to remove the tubing and release the clip to open it back up. Some have had valves to prevent bottom-up priming at all (which bugs the snot out of me because then I have to unhook the whole system and re-prime).

If the tubing was still in the IV pump, it didn't prime because the tubing was clamped inside the pump. That also means there's no way the air would get down the tubing to the patient if you're flushing/pulling from a low port.

But if you are unsure how to safely perform a procedure or if you have done something that might harm a patient, the place to start is someone who is there with you at the time of the concern.

[smac07]

Just remember to clamp the iv that is attached the patient. Then do what you have to do. Flush the line then add new bag.