Clearing lines for pump.

icuRNmaggie, BSN, RN · Apr 8, 2015

Which IV pump are you using?

psu_213, BSN, RN · Apr 8, 2015

With IV ABX, set up a piggyback with your ABX as a secondary--back prime that line and you won't waste any of the ABX.

Also, don't fret too much over one small bubble. No, you should not have a large number of bubbles, but a small amount of air is not going to harm your patient.

annie.rn · Apr 8, 2015

Have you tried pulling the tubing really taut and then flicking it (like you would a syringe) to get the bubbles out? The bubbles will float up into the drip chamber and disappear. You may have to flick the chamber as well. That works well for me when there are a lot of tiny bubbles in the tubing. This will only work for bubbles above the cassette, of course.

I try to only run abx. on a secondary line, using a small bag of NS at KVO as the primary (if fluids aren't ordered). This way, your abx. won't run dry, causing air in the line. (That's assuming you program the pump correctly.) Also, if you do get bubbles, you can back prime into a 10 or 20 cc syringe connected to the secondary port.

It's a bit of a pet peeve of mine when intermittent abx. are run on a primary set. If it's a 50cc bag of abx., a lot of the abx. are lost priming the set and being left in the tubing in between doses.

Hope this helps. Also, don't worry too much about getting every tiny bubble out of the tubing. Unless they are causing the pump to alarm, they won't be a problem or harm the patient.

annie.rn · Apr 8, 2015

Sorry for duplicating the advice of psu_213. I was typing my reply while psu_213's posted and didn't see it. :-)

OwlieO.O · Apr 8, 2015

Which IV pump are you using?

Plum pump

OwlieO.O · Apr 8, 2015

Have you tried pulling the tubing really taut and then flicking it (like you would a syringe) to get the bubbles out? The bubbles will float up into the drip chamber and disappear. You may have to flick the chamber as well. That works well for me when there are a lot of tiny bubbles in the tubing. This will only work for bubbles above the cassette, of course.
I try to only run abx. on a secondary line, using a small bag of NS at KVO as the primary (if fluids aren't ordered). This way, your abx. won't run dry, causing air in the line. (That's assuming you program the pump correctly.) Also, if you do get bubbles, you can back prime into a 10 or 20 cc syringe connected to the secondary port.
It's a bit of a pet peeve of mine when intermittent abx. are run on a primary set. If it's a 50cc bag of abx., a lot of the abx. are lost priming the set and being left in the tubing in between doses.
Hope this helps. Also, don't worry too much about getting every tiny bubble out of the tubing. Unless they are causing the pump to alarm, they won't be a problem or harm the patient.

Okay, that makes a lot of sense. What would be the best way to expel air from the secondary line you just connected?

OwlieO.O · Apr 8, 2015

Oh, plus I like the idea of doing anything other than NS, LR, or whatever for other meds cause they usually need to be diluted, and I can stop line A if they don't need diluting.

icuRNmaggie, BSN, RN · Apr 8, 2015

Yes, you need to invert the cassette to get to prime the tubing. If I recall correctly, you can also attach a syringe to the cassette to remove those annoying champagne bubbles that tend to accumulate.

OwlieO.O · Apr 8, 2015

I just figured it out. You can back-prime into the drip chamber of the piggy-back. Got it!

OwlieO.O · Apr 8, 2015

Yes, you need to invert the cassette to get to prime the tubing. If I recall correctly, you can also attach a syringe to the cassette to remove those annoying champagne bubbles that tend to accumulate.

Yeah, for some reason they got mad at me for back-priming. Seems simpler to me, but oh well.

Julius Seizure · Apr 9, 2015

Also, prime the tubing slowly. Slower = less bubbles!