Do you burp IV bag prior to putting pressure on it?

[Nurse Beth, MSN]

I have never burped an IV bag before putting pressure on it.

The times I've used pressure are for art lines and blood transfusions, and the bag is already spiked with tubing primed.

I don't believe there is evidence to support burping. I'm interested to hear about other nurse's practices ?

[marienm, RN, CCRN]

I get all the air out of A-line tubing by flipping the bag over, applying pressure, and priming the tubing.  Air normally rises to the top of the bag, so a hanging bag is fine but if you rest the bag on the patient during transport/scan, theoretically the air could find its way out the tubing and into the artery.  

For the same reason, I would burp IV fluid bags before infusing by gravity (pressure bag or no) but only if I was planning to go somewhere with the patient.  If I was just pressure-bagging one bolus I wouldn't bother, and I don't bother with all my normal med/IV fluid lines that are on the pump.

[LovingLife123]

offlabel said:

It's to avoid an air embolus while giving crystalloids under pressure or intra arterial air with an a line. Probably not a bad idea but not absolutely necessary if the RN is attentive. 

I've given hundreds of fluids with a pressure and set up arterial lines daily.  Never once have I burped a bag.  Any air goes to the top of the bag.  

[LovingLife123]

No, I've never burped a bag before putting a pressure bag on it.  I spike, prime, then put a pressure bag on.  
 

Do people still burp IV bags?  

[Nurse Alexa, MSN, RN]

I think "burping" the bag is the old school way of learning priming the tubing. However, I do believe it is important to get all the air out of your pressurized tubing before connecting it to the patient.

If "burping" the bag isn't your thing, then flushing the bag will suffice to get all the air out. 

[Lynker, LPN]

LovingLife123 said:

No, I've never burped a bag before putting a pressure bag on it.  I spike, prime, then put a pressure bag on.  

Do people still burp IV bags?  

I've never heard of putting a pressure bag on. What do you mean? I'm still a newbie with IVs, though.

[Nurse Beth, MSN]

Lynker said:

I've never heard of putting a pressure bag on. What do you mean? I'm still a newbie with IVs, though.

They look like this. Although I recall squeezing a bag of blood with my hands to make it go in faster ?. Same effect

[offlabel]

It's to avoid an air embolus while giving crystalloids under pressure or intra arterial air with an a line. Probably not a bad idea but not absolutely necessary if the RN is attentive. 

[offlabel]

Good for you. Sounds like you were being careful. Sometimes pressure bags are taken off IV poles and laid on the bed during transport/transfer of the patient whether by ambulance or gurney. Air can get into the tubing system that way. If you don't feel the need, then don't do it. 

Here are examples of what can happen if you don't pay attention:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766770/

https://www.longdom.org/open-access/inadvertent-venous-air-embolism-from-pressure-infuser-bag-confirmed-by-transesophageal-echocardiography-2155-6148.1000169.pdf

Plenty more where that came from if you choose to look. 

[Nurse Beth, MSN]

Coban

[Checkers08, BSN, MSN, RN]

Nurse Beth said:

They look like this. Although I recall squeezing a bag of blood with my hands to make it go in faster ?. Same effect

I've wrapped Coban around a bag in a pinch too when my hands were needed elsewhere!