Clearing lines for pump.

Nursing Students Student Assist

Published

Okay, so I'm having a hard time trying to clear my lines of bubbles without wasting too much fluid when I'm setting up a pump. I wasn't told at first to invert the cassette, then figured it out with another student. Even then I still get these latent bubbles (even just one) and waste lots of fluid trying to expel them.

So how do I not waste so much fluid? I'm not worried about NS or something, but IV antibiotics or something that has to be exact and not wasting seems like a pain. I could back prime, but they get mad when I back prime. The only thing is if I back prime I can at least push the leftover med with a syringe pump or something.

Up Vote Up Vote ×
Specializes in MICU, SICU, CICU.

Which IV pump are you using?

Up Vote Up Vote ×
Specializes in Emergency, Telemetry, Transplant.

With IV ABX, set up a piggyback with your ABX as a secondary--back prime that line and you won't waste any of the ABX.

Also, don't fret too much over one small bubble. No, you should not have a large number of bubbles, but a small amount of air is not going to harm your patient.

Up Vote Up Vote ×

Have you tried pulling the tubing really taut and then flicking it (like you would a syringe) to get the bubbles out? The bubbles will float up into the drip chamber and disappear. You may have to flick the chamber as well. That works well for me when there are a lot of tiny bubbles in the tubing. This will only work for bubbles above the cassette, of course.

I try to only run abx. on a secondary line, using a small bag of NS at KVO as the primary (if fluids aren't ordered). This way, your abx. won't run dry, causing air in the line. (That's assuming you program the pump correctly.) Also, if you do get bubbles, you can back prime into a 10 or 20 cc syringe connected to the secondary port.

It's a bit of a pet peeve of mine when intermittent abx. are run on a primary set. If it's a 50cc bag of abx., a lot of the abx. are lost priming the set and being left in the tubing in between doses.

Hope this helps. Also, don't worry too much about getting every tiny bubble out of the tubing. Unless they are causing the pump to alarm, they won't be a problem or harm the patient.

Up Vote Up Vote ×

Sorry for duplicating the advice of psu_213. I was typing my reply while psu_213's posted and didn't see it. :-)

Up Vote Up Vote ×
Which IV pump are you using?

Plum pump

Up Vote Up Vote ×
Have you tried pulling the tubing really taut and then flicking it (like you would a syringe) to get the bubbles out? The bubbles will float up into the drip chamber and disappear. You may have to flick the chamber as well. That works well for me when there are a lot of tiny bubbles in the tubing. This will only work for bubbles above the cassette, of course.

I try to only run abx. on a secondary line, using a small bag of NS at KVO as the primary (if fluids aren't ordered). This way, your abx. won't run dry, causing air in the line. (That's assuming you program the pump correctly.) Also, if you do get bubbles, you can back prime into a 10 or 20 cc syringe connected to the secondary port.

It's a bit of a pet peeve of mine when intermittent abx. are run on a primary set. If it's a 50cc bag of abx., a lot of the abx. are lost priming the set and being left in the tubing in between doses.

Hope this helps. Also, don't worry too much about getting every tiny bubble out of the tubing. Unless they are causing the pump to alarm, they won't be a problem or harm the patient.

Okay, that makes a lot of sense. What would be the best way to expel air from the secondary line you just connected?

Up Vote Up Vote ×

Oh, plus I like the idea of doing anything other than NS, LR, or whatever for other meds cause they usually need to be diluted, and I can stop line A if they don't need diluting.

Up Vote Up Vote ×
Specializes in MICU, SICU, CICU.

Yes, you need to invert the cassette to get to prime the tubing. If I recall correctly, you can also attach a syringe to the cassette to remove those annoying champagne bubbles that tend to accumulate.

Up Vote Up Vote ×

I just figured it out. You can back-prime into the drip chamber of the piggy-back. Got it!

Up Vote Up Vote ×
Yes, you need to invert the cassette to get to prime the tubing. If I recall correctly, you can also attach a syringe to the cassette to remove those annoying champagne bubbles that tend to accumulate.

Yeah, for some reason they got mad at me for back-priming. Seems simpler to me, but oh well.

Up Vote Up Vote ×
Specializes in Pediatric Critical Care.

Also, prime the tubing slowly. Slower = less bubbles!

Up Vote Up Vote ×
+ Add a Comment