Backpriming question from student

[RamaMama]

Hello, I am a student currently assigned to ICU. I'm a little confused about how to backprime, I hadn't seen this untill this rotation. I understand you drop the secondary bag down lower than the primary bag so the primary solution flushes the saline or other fluid through the secondary line so that you do not have to change/waste tubing.

Do you hold the old secondary bag down low (both primary/secondary unclamped) till fluid flows into the bag and then clamp the line, raise it back up and spike a new secondary bag, unclamp and you are ready to go?

Thanks in advance for any clarification.

[detroitdano]

Let the primary line run, spike your piggyback, then hold the piggback lower than the primary line. Let it fill up the drip chamber enough to kick air out of the piggyback's line as well, otherwise you'll be flushing air out in a matter of minutes once you start the piggyback. Once it's backprimed, just move the piggyback higher than the primary and you're good to go.

[RamaMama]

Thanks for the reply. I guess I should mention that the scenario I am referring to is not when you are changing the secondary bag to the exact same med but when you are changing to a new med, say a different antibiotic than what was originally hanging. So rather than change the tubing, back prime to flush all the old antibiotic out of the line, and then spiking the new antibiotic. Does that make sense?

[detroitdano]

If it's a different antibiotic just get a different set of tubing so you're not worrying about compatibility, then when you get another dose of the same med, just backprime like I mentioned.

[RamaMama]

I was thinking about that...but this is the way they do it on the unit, including my preceptor. Thanks for your help!

[WSU_Ally_RN, BSN, RN]

I don't like to do it that way, but sometimes I have to (stuck in a isolation room, no one able to grab me another secondary set...) I will lower the secondary tubing lower than the primary and let the old bag of atb fill with some primary fluid. I will then clamp my secondary tubing, and squeeze some fluid out of the drip chamber into old bag. Spike my new bag, unclamp, and I'm ready to go :)

[WindwardOahuRN, RN]

Hello, I am a student currently assigned to ICU. I'm a little confused about how to backprime, I hadn't seen this untill this rotation. I understand you drop the secondary bag down lower than the primary bag so the primary solution flushes the saline or other fluid through the secondary line so that you do not have to change/waste tubing.

Do you hold the old secondary bag down low (both primary/secondary unclamped) till fluid flows into the bag and then clamp the line, raise it back up and spike a new secondary bag, unclamp and you are ready to go?

Thanks in advance for any clarification.

You could clamp it, I guess, but I just bend over the tubing which acts as a temporary clamp after holding the secondary bag down and filling the line with the primary fluid. Then I spike the new secondary bag and go on.

Your instructors might want you to clamp the line after it fills with the primary fluid but then again, they often are not living in the real world of nursing.

Go with what your instructors want. When you are working for real you will adapt.