Mistake that cannot be done by nurse - page 2
by deepurple 5,467 Views | 21 Comments
yesterday, i'd been made mistake. When i'm flush the neck line with hepsaline at pt who is a nearly 1 year old baby, there is bubble when i withdraw little bit blood to see whether the line is functioning well or not but i didn't... Read More
- 0Apr 6, '12 by deepurpleOne of my senior staff nurse who taught me how to avoid injecting the air into the line. I think like what you have said, lock the syringe into the stopcock and point upwards 90 degree and tap the syringe so that the air is going upward and then the bubble will not go into the line. Isn't it?
- 0Apr 7, '12 by NotReady4PrimeTime Senior ModeratorIt's not exactly the same thing. It will work, because then you can aspirate the bubble into the syringe. As long as you keep everything at that 90 degree upward position the bubble with go to the plunger end of the syringe and therefore not be injected into the patient. I still hope to get the photos I talked about but it has been VERY busy on my unit this weekend and tomorrow will be worse still, so I may have to try something else to show you what I mean.
- 3Apr 15, '12 by NotReady4PrimeTime Senior ModeratorI finally had time to make my little photo tutorial for you.
Starting point with cap on stopcock.
Air in the dead space
Hold the syringe at a 90 degree angle to the port and drip flush into port.
If you drip slowly and smoothly there are no bubbles. Flick the stopcock if needed.
You should have a dome of fluid on the port like this.
When you attach the syringe to the port, the dome of fluid will "spill" and you'll have an air-free connection.
This is how we ensure air-free connections on our ECMO circuits, where even a microscopic bubble could be catastrophic. Does this help?
- 0Apr 15, '12 by deepurpleThank you for sharing this knowledges with me....It is really helpful. The syringe also must be free of bubble to right? have you see some nurses connected the syringe first and syringe out ...to see whether there is bubble or not.If there is bubble come out, they will syringe out the bubble then they flush the line.
- 1Apr 15, '12 by NotReady4PrimeTime Senior ModeratorYes, that can also be done, but it won't work if you're unable to get blood back into the line. All you'll do is create a vacuum. If that's how you choose to clear any air from the dead space in your port, you MUST hold the syringe vertically so that the air will rise to the plunger end and away from the port. And you have to be absolutely sure you've flushed ALL of the blood out of the line so that there won't be a clot or a strand of fibrin forming at the tip that will occlude your lumen when you attempt to aspirate later.
- 0Jul 5, '12 by deepurpledear janfrn
i had a problem when taking blood pressure with blood pressure machine.
i'm still new i pediatric ward. there must be some tips or technique in taking blood pressure for them. the most important thing is i want to know how to put the cuff blood pressure at the right position at the leg.