Mistake that cannot be done by nurse - page 3

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. by   NotReady4PrimeTime
    I finally had time to make my little photo tutorial for you.


    starting-point-jpg
    Starting point with cap on stopcock.
    cap-removed-jpg
    Cap removed.
    air-space-in-
    Air in the dead space
    .preparing-to-prime-
    Hold the syringe at a 90 degree angle to the port and drip flush into port.
    priming-jpg
    If you drip slowly and smoothly there are no bubbles. Flick the stopcock if needed.
    primed-jpg
    You should have a dome of fluid on the port like this.
    spilling-jpg
    When you attach the syringe to the port, the dome of fluid will "spill" and you'll have an air-free connection.
    flushing-without-bubbles-
    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?
  2. by   deepurple
    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.
  3. by   NotReady4PrimeTime
    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.
  4. by   deepurple
    Thank you so much janfrn..you are really helping me....
    What should i call you? May i know your name?
  5. by   deepurple
    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.
  6. by   NotReady4PrimeTime
    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.
  7. by   canned_bread
    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...!
  8. by   NotReady4PrimeTime
    Quote from canned_bread
    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...!
    I'm happy that it helped.
  9. by   wooh
    Quote from janfrn
    I finally had time to make my little photo tutorial for you.
    Nice work!

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