Ahh! Huge mistake

[Mattsgrl83]

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.

[Penelope_Pitstop, BSN, RN]

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.

not to hijack the thread, but imagining this happening to a dog makes me very sad.

back to our scheduled topic...

all nurses make mistakes, it's the good nurses who own up to them!

[NightNurseRN]

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.

Thats horrible! Poor dog

[emnicams]

How sad re: the dog experiment. Why not just accept that air in an IV can kill a person and take every possible step to prevent it? What is the point in purposely killing a dog just to find out exactly how much it takes?

[NurseWannabe1129]

:offtopic:

I think most of us in (or going into) the nursing profession realize the value of someone who can admit to their mistakes.. Cheer up, I don't think you have anything to worry about!

[IVRUS, BSN, RN]

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.

As a previous poster said, many of your elastomeric devices (like the one you described) come pre-primed (and your pharmacy should label it as such) But, it is also extremely difficult to ascertain this as you will be looking at micro-bore IV tubing. Microbore IV tubing is much smaller in diameter than your other tubing sets, but in this case, that's a good thing as its priming volume is usually 2-4 mls. That amount of air will NOT kill an adult.

I am glad that you were able to remember to follow policies when someone has suffered an air-embolism, however, in this case, it really wasn't needed.

I pray that one day soon, you'll rebuild your confidence. You are a asset to the nursing profession - Keep up the good work!