Cleaning up lines

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It's called a manifold. There are some that are manufactured this way or you just screw together however many you need and attach to your lumen.

IF making your own, do use caution and check frequently that they do not become disconnected (lots of places to come loose when you make your own manifold). You can easily have your dopa gtt running into the patients bed and not have any idea why your blood pressure is sinking....

Great question!! I agree with the manifold: it is literally the best thing invented!!!

I definitely agree with everyone's advice! When I go into my room to do a gtt check at change of shift I always check my lines. I make sure they are all dated and labeled. I label my lines in 3 places: going into the pump, coming out of the pump, and at the port. We are also required to select a drug on every pump so that you can clearly see which pump is running what. If I need to look up any drug compatibilities I will just go ahead and input all of the drips my patient is on and print that off so that the next nurse has it. That way they don't have to spend time looking up what I have already looked up and if they need to change around the lines they can already see what is compatible. I always try to consolidate all of my lines right away as well. That just makes things easier later on if something needs to be changed or I need an open port.

I definitely agree with everyone's advice! When I go into my room to do a gtt check at change of shift I always check my lines. I make sure they are all dated and labeled. I label my lines in 3 places: going into the pump, coming out of the pump, and at the port. We are also required to select a drug on every pump so that you can clearly see which pump is running what. If I need to look up any drug compatibilities I will just go ahead and input all of the drips my patient is on and print that off so that the next nurse has it. That way they don't have to spend time looking up what I have already looked up and if they need to change around the lines they can already see what is compatible. I always try to consolidate all of my lines right away as well. That just makes things easier later on if something needs to be changed or I need an open port.

I agree but I am curious why you label the line "going into the pump and coming out of the pump"?

I agree but I am curious why you label the line "going into the pump and coming out of the pump"?

OCD

I don't personally, but have seen some that do, and it can help if you have 8+ lines on the same pole that has 2 pumps on it.

I agree but I am curious why you label the line "going into the pump and coming out of the pump"?

When I had kids with multpile drips I would walk the line from the bag to the pump, label the line, make sure the pump label was correct then walk the line from the pump to the patient and label again. Part of this habit came from being a nurse before pumps had drug libraries. We had to know which pump was infusing which drip. We had little cards on the actual pumps but they sometimes fell off and sometimes the labels on the patient side would too.

I get the purpose of labeling lines and even pumps if they aren't smartpumps, but I'm not getting why would label the tubing just above as well as just below the pump.

I get the purpose of labeling lines and even pumps if they aren't smartpumps, but I'm not getting why would label the tubing just above as well as just below the pump.

Because when you go to titrate it's quicker to look at a labeled pump than track the tubing back from the patient. The label I put on the patient side was at the manifold.

Because when you go to titrate it's quicker to look at a labeled pump than track the tubing back from the patient. The label I put on the patient side was at the manifold.

They get that, they are asking why NewGradNurse2014 puts a label on the tubing between the bag and pump (normal), then a label at the distal end of the tubing (also normal) but then a 3rd label on the tubing just after the pump (not the norm).

Managing your lines is something that will come with experience. I remember being a new nurse, and tracing my lines over and over and over to make sure I knew where everything was going. We do the 3 labels thing, with one at the patient, one by the bag, and one directly on the pump--our pumps don't show the drug name when they are on hold. I like to know at a glance that my pressor is running, not on hold!

Yes, you can disconnect just about anything for a few seconds, even your pressors, just make sure you know exactly where you are going with it before you disconnect it. Pressure cables can be unhooked, you will just have to re-zero them once you reconnect. You can disconnect your suction tubing (ETT, OGT, etc.), just make sure no secretions are going to come dripping (or flying) out. :)

There are a few reasons I label my lines in 3 places. 1. Yes, I will admit I am a tad OCD lol 2. I am a new ICU nurse and I have been a nurse for just under a year (which I think helps contribute to my OCD-like traits ). I am always double and triple checking everything. 3. I guess that's just kind of the norm where I work. That's how my preceptor did it and I see many other nurses do the same thing. It's just super easy to glance at the pump/lines and know what everything is. And often, like a couple people have mentioned when a patient is on multiple gtts and there are many lines it's easier to glance at them and know what they are in a few seconds, especially in an emergency. I guess I wasn't aware how abnormal some people view this to be? lol

Oh and as far as lines/tubes in general, the best advice I got as a new nurse was to put the most important lines on top and to try and keep lines on both sides of the patient balanced. For instance you would never put any cords above or tangled with your vent tubing as that is more important so there would be no reason for a vent to become disconnected due to other lines/tubes. And let's say you would have your vent tubing, IV lines and art/CVP lines on one side of a patient, then you would put your blood pressure cuff, pulse ox, and tele leads on the other side. Those might not be the best examples, but hopefully it made sense. I know it seems simple but it always going back to those basics really has helped me out.

Oh my - the dreaded spaghetti lines I call them!

So, with the lines connecting the patient to the monitors, I unplug them one at a time from the monitor (beep beep! says the monitor), thread it out and around the other wires, and plug it back in. And then the next one, and the next one. Until all the monitor lines are nice and ordered. If it is a super sick or long term patient, sometimes I label the lines with blank labels. Some hospitals may not be able to do this I imagine. Never take things like defib patches off the patient and then restick them back on. Instead unplug from the machine and do it that way.

For the drugs, I look at the drugs and think "can i disconnect this?". If it is a no, I leave it. If it is a yes, but only for a short time, I do it last and quickly when the others have been disconnected and reconnected neatly. If its okay to disconnect, I disconnect it from the machine (never from the patient, as this would make a break in the sterile connection) and thread it through the spaghetti and back in. Ordered one after the other.

Honestly, I have had times when the patient has come in in such a mess, and then I have done initial caring and then taken a good 20 minutes making the lines and patient all clean and neat. It makes SUCH a big difference! I think I am a bit of a neat freak! Plus it looks so much better for family, and for doctors, and for when you hand the patient over. It also can be a time when you look at the bags and medicines and double check that everything is right, dosages are right, that the handover was right, or if there is any mess on the pumps.

Sometimes it can be hard when you have a really really busy shift or a really really intense patient to do it. Neatness isn't a priority, the PATIENT itself is a priority. So in those cases it's only when I am hanging up a new line that I keep it untangled from the spaghetti to not make it worse.