Priming potassium lines

Nurses Medications

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Is there a better way to prime a primary line when you're running potassium? As of now, I prime the line with the potassium (since, as far as I know, you can't back prime the primary line) - but I find that part of the first run gets wasted because I have to let the fluid run a little to get rid of the bubbles that inevitably appear in the line, even if I prime slowly. Because of this wasting, most often my first run of potassium goes dry before 100 mls have infused. Thanks!

offlabel

1,557 Posts

You're using secondary tubing for the K, yeah? Just back prime into that with the primary fluid. No big deal.

Specializes in NICU, RNC.

I just had to get checked off yesterday for priming a primary line with an antibiotic and not wasting any of it. My best advice is: 1. go slowly (which you said you're already doing). 2. invert the valves as you prime so that they fill with the medication rather that creating air bubbles. 3. as soon as a bubble appears, clamp the line, and start flicking it to the top right away so that it doesn't end up near the end and then having to either waste med or sit there for 5 minutes flicking it all the way back up the tubing.

VANurse2010

1,526 Posts

Why are you running potassium piggybacks as a primary? Just get a small bag of NS and piggyback it. Waste problem solved.

cleback

1,381 Posts

Never heard of k as a primary except in the er. We run ours as a secondary infusion, attached to a primary infusion to dilute it further. I would think running it as a primary would hurt like heck? Are yours the same concentration of 10 mEq/100ml?

GM2RN

1,850 Posts

It's policy at my hospital to run potassium on primary and on its own pump.

It's impossible to run it as a piggyback and have it diluted because the pump will infuse either the piggyback or the primary but not both at the same time.

If my patient is able to have the fluids, I'll add the potassium to a liter bag of NS and run it at the appropriate speed for dilution purposes. If not, then I will run potassium and NS, each on their own pumps in order to control infusion rate and amount of NS.

As for priming, I agree with the previous advice to go slow, etc.

Mr. Murse

403 Posts

Specializes in Critical Care/Vascular Access.

Why is priming a line with K any different than priming any other line?

As for bubbles, frankly, you'd have to run a huge portion of tubing full of air to risk an air embolus, a couple of tiny bubbles honestly doesn't matter.

Lastly, in response to one of the replies, running a secondary/piggyback doesn't dilute the secondary fluid at all and is really no different than running a primary as far as diluting the fluid is concerned.

cleback

1,381 Posts

You're right--piggybacking does not dilute it but running it into an existing primary line does. Sorry for the confusion.

Specializes in ICU.

The Plum pumps can run a secondary and a primary line at the same time, so it is definitely possible to dilute a secondary if you have the right IV pump. Just saying.

I have worked places where it was policy to run potassium as a primary line, which is ridiculous IMO. There is no avoiding wasting potassium when that's the policy. The only way to not waste any is to run it as a secondary, which may or may not follow the policy at OP's place of work.

GM2RN

1,850 Posts

You're right--piggybacking does not dilute it but running it into an existing primary line does. Sorry for the confusion.

Im not exactly sure what you are saying here. The only way that this works is to have both K and fluids on primary tubing, each on their own pump and connected to each other below the pumps. Or, apparently if using a Plum pump, which I'm not familiar with.

GM2RN

1,850 Posts

Why is priming a line with K any different than priming any other line?

As for bubbles, frankly, you'd have to run a huge portion of tubing full of air to risk an air embolus, a couple of tiny bubbles honestly doesn't matter.

Lastly, in response to one of the replies, running a secondary/piggyback doesn't dilute the secondary fluid at all and is really no different than running a primary as far as diluting the fluid is concerned.

I agree with regard to an air embolus, but the pumps we use are quite sensitive to air bubbles and won't run unless they are pretty much non-existent.

blackvans1234

375 Posts

If my patient is able to have the fluids, I'll add the potassium to a liter bag of NS and run it at the appropriate speed for dilution purposes.

oy, sounds like a bad idea.

so does 4 runs of k = 4,400mL? (1L + 100mL of k X4?)

Also, how fast do you run the liter bag with k? 1 hour? #bolus #diluting the k anyway

haha.

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