Mistake that cannot be done by nurse - page 2

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... Read More

  1. 0
    You could do that morte, and I have. But if I'm planning to flush the line already and have the flush syringe in hand it's quicker and easier to just spill-prime.

    Get the hottest topics every week!

    Subscribe to our free Nursing Insights newsletter.

  2. 0
    One 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?
  3. 0
    It'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.
  4. 3
    I finally had time to make my little photo tutorial for you.

    Click image for larger version. 

Name:	Starting point.jpg 
Views:	161 
Size:	90.1 KB 
ID:	10568
    Starting point with cap on stopcock.
    Click image for larger version. 

Name:	Cap removed.jpg 
Views:	144 
Size:	83.8 KB 
ID:	10570
    Cap removed.
    Click image for larger version. 

Name:	Air space in hub.jpg 
Views:	160 
Size:	93.1 KB 
ID:	10572
    Air in the dead space
    .Click image for larger version. 

Name:	Preparing to prime.jpg 
Views:	175 
Size:	87.5 KB 
ID:	10574
    Hold the syringe at a 90 degree angle to the port and drip flush into port.
    Click image for larger version. 

Name:	Priming.jpg 
Views:	150 
Size:	96.3 KB 
ID:	10576
    If you drip slowly and smoothly there are no bubbles. Flick the stopcock if needed.
    Click image for larger version. 

Name:	Primed.jpg 
Views:	143 
Size:	93.8 KB 
ID:	10578
    You should have a dome of fluid on the port like this.
    Click image for larger version. 

Name:	Spilling.jpg 
Views:	150 
Size:	104.7 KB 
ID:	10580
    When you attach the syringe to the port, the dome of fluid will "spill" and you'll have an air-free connection.
    Click image for larger version. 

Name:	Flushing without bubbles.jpg 
Views:	152 
Size:	90.3 KB 
ID:	10582
    Bubble-free flushing.

    This is how we ensure air-free connections on our ECMO circuits, where even a microscopic bubble could be catastrophic. Does this help?
    Hygiene Queen, wooh, and deepurple like this.
  5. 0
    Thank 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.
  6. 1
    Yes, 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.
    deepurple likes this.
  7. 0
    Thank you so much janfrn..you are really helping me....
    What should i call you? May i know your name?
  8. 0
    dear 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.
  9. 0
    I know you've read the reply that Ashley, PICU RN posted into the thread you started with this question. There's not much I can add.
  10. 0
    That photo tutorial was fantastic! I never knew that, I always just did everything at 90 degrees letting gravity help me, and watched and flicked and fiddled...!

Nursing Jobs in every specialty and state. Visit today and Create Job Alerts, Manage Your Resume, and Apply for Jobs.