"Looping" IV Tubing

CritterLover, BSN, RN · Aug 14, 2007

if i'm understanding what you are talking about, i see it done all the time, and it makes me cringe.

(you are talking about when you disconnect the iv tubing, taking the end that goes into the iv and connecting it to a secondary port, seemingly keeping it sterile, right?)

our hospital policy does not endorse the practice, but it doesn't stop people from doing it. i never saw this in any other part of the country, so i thought it was a regional thing. maybe not.

i was taught to keep the end of the tubing sterile by putting a new needle on the end, complete with sterile cap.

Altra, BSN, RN · Aug 14, 2007

I think I understand what you're saying. Example - patient wants to get up to go to bathroom, tubing clamped, Luer lock ("alligator clip") disconnected from patient and inserted into another port along the tubing to keep end from flapping around until patient returns and is reconnected.

I have not read the INS guidelines. Why does this "make you cringe" and what would be an acceptable "sterile covering"? I will admit I've never given this a second thought, but the only alternative I can think of would be to leave the tubing hanging on the pole and use a new Luer lock when the patient returns? Is there real benefit to this?

AprilRNhere · Aug 14, 2007

Why isn't this acceptable. I was taught to do this..of course after cleaning the port with an alcohol wipe. Is it any different than flushing a locked IV? We wipe and flush those.

AprilRNhere · Aug 18, 2007

I'd like to bump this for further explanation. I did some searching online..but everywhere I found IV procedures it tells to loop it. Why is the port good enough to use for injections...but not for looping?

AprilRNhere · Aug 18, 2007

anyone have an answer?

danh3190 · Aug 18, 2007

My instructor actually recommended "looping" the IV during my last rotation. Some of the floor nurses just replaced the alligator clip.

PICC ACE · Aug 20, 2007

Above all,the manufacturer's directions and IFU's need to be followed. I doubt that any company would ever advocate this practice. Injection ports are made for injections,not for "looping". There are end caps available that are designed for the purpose of protecting the end of the line when disconnected.

Can you keep the lines and connections clean and sterile using "looping" or other means? Maybe. Are these other means consistent with national standards and manufacturers' IFU's. No. One other thing to consider in this litigious society is liability. If the unlikely,worst-case scenario happens and you ever have to be in court over an IV-related incident,it wouldn't look so good.

A link:

http://www.iv-therapy.net/node/503

I am curious to see websites that advocate this procedure--any references/links would be appreciated.

cardiacRN2006, ADN, RN · Aug 20, 2007

We do it all the time, and I don't see a problem with it.

Agnes Anne · Sep 21, 2007

My guess is for the most part, nurses "loop" when they're in a hurry and do not spend an adequate amount of time cleaning the port before making the connection. That is if they really clean it at all. I've seen alot of them just loop wiht out cleaning in a pinch.

I carry both the male and the female connectors so I can always protect the sterility of the tubing... and then I get caught without one

It's darn tempting though.

elizabells, BSN, RN · Oct 5, 2007

I usually put a new alligator clip on and then tear one corner off an alcohol swab and tuck the end of the tubing into the packet. I've never seen looping - but I'm not sure the tubing we use on my unit would support it. I can visualize it in theory, but not with the specific tubings and connectors that we use.

cardiacRN2006, ADN, RN · Oct 5, 2007

How is looping any different then when I plug 2 compatible meds into one line?

It isn't. That's why there is nothing wrong with this practice.