Published Jul 26, 2009
I'm a first year new grad. Friday night I was working at my job as an RN in a TCU. I had a patient who was put on IV ABX. I haven't had a patient on IV's since nursing school. In the nursing home we use vaccum filled balls called acu flo for IV's. They hold 100ml of ABX and flow at a rate of 100ml per hour. The tubing is much smaller than a regular IV, maybe hold 3-5cc. I flushed the line with saline. Hooked the patient up to the IV and unclamped the tubing. OH no then I realized I forgot to prime the line and what seemed like immediately clamped the line and unhooked the tubing...too late the tubing was now full of liquid. I turned the patient to her left side. Notified the supervisor and called the on call MD. The On call told me he did not anticipate there being any problems but to monitor the patient for signs and symptoms of respiratory distress or SOB. I wrote up an incident report on the situation. Patients vitals were stable and when I left my shift 2 1/2 hours later she was still fine. I called back 5 hours later and night nurse reported patient was 100% ok. I am so nervous about this and know I wont find anything out until Monday. Ahhh I wonder if I will loose my job for this awful error.
I know the type of IV administration tool you're using and it really does hold very little air in the tubing (actually, the type we use comes pre-primed, don't even have to worry about air!), and it's really doubtful this amount of air would hurt anyone. You did the right thing following the incident, covered all your bases, and let's face it, I'm sure you'll never do it again!! Don't worry so much over it, the pt. is fine and this truly is not something you should lose your job over.
Good job on stepping up and accepting responsibility for your mistake! Its the sign of a good nurse and is ALWAYS better then simply ignoring a problem or denying it.
Second...I've heard so many anecdotal stories about how much air through IV tubing is actually required to cause damage. Honestly, I don't have a specific number but the trend seems to range from a full tubing worth to several full tubings worth. I think if instant death followed every time a mistake like yours was made there would be a lot more hospital related deaths. Maybe an expert can jump in here with more specific info?
An anesthesiologist once told me you would need at least the whole length of the IV tubing full of air to do any harm.
Don't worry about it. The patient is fine, you accounted for your mistake, you are going to be fine. :)
I think it is great that you owned up to your mistake and took the right steps afterwards. I have charged over many nurses who i KNOW would never admit they made mistakes and i felt i had to watch them like a hawk. i see your a new nurse, mistakes WILL happen, were human, we must always be honest when they do. way to go! btw I think your patient is fine and you have no reason to be fired.
You've taken all the right steps, and learned a lesson. Great job! You couldn't have done anything different, except ignored the situation, and that's definitely not the right answer.
PostOpPrincess, BSN, RN
You did good. And if you get fired for this...we would lose a good nurse--so I have a feeling you are a keeper.
I agree with everyone else. Good job taking responsibilty!
You did great job accepting the mistake you've done...many of them won't accept it...specially those old Nurses...
Oh man..........i've been seeing too many mistakes they had done but still they'll make reasoning....trying to escape from it!!!
I'm a new RN also and I made the mistake of giving someone 30meqs of K when their K level was 5.2...I went right to my clinical coordinator and told her and we called the MD and they were not too concerned. We rechecked the K level and it came back 4.9...Moral of the story (as everyone else said) accept your mistake and what is done is done, no harm; no foul. I thought I was going to lose my job too but I'm still working. So don't sweat it, **** happens...You did everything right.
I've always heard the 30 ml of air before needing to worry also (about what it takes to prime the tubing). A friend worked in an animal research lab where they did different medical related experiments. One for air embolism they instilled air via a central venous line until there was a problem. At 60 ml of air the dog became tachycardic and blood pressure raised about 40 points systolic. At 120 ml of air the dog coded. These were on about 75 pound hunting dogs.
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