Filling IV tubing drip chamber for flight tips?

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Specializes in Flight nurse.

I have scoured the Internet but did not find any thing that would help. Our practice in flight regarding IV infusions is to fill the drip chamber entirely so there is no air present. When priming tubing, can someone give me a reference or tips for getting every little bit of air out? Thank you.

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Specializes in CEN, Firefighter/Paramedic.
On 7/8/2022 at 5:56 PM, Stephanie Marsh said:

I have scoured the Internet but did not find any thing that would help. Our practice in flight regarding IV infusions is to fill the drip chamber entirely so there is no air present. When priming tubing, can someone give me a reference or tips for getting every little bit of air out? Thank you.

Is there any EBP for this?  I haven't flown for about 10 years, but we never did this..

 

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Specializes in Flight nurse.
41 minutes ago, FiremedicMike said:

Is there any EBP for this?  I haven't flown for about 10 years, but we never did this..

 

Hi Mike thanks so much for responding. I do not have any evidence base practice resources to cite. However, if our patient is only on 1 to 2 drips, we lay the pumps on the patient. Because of this and our very sensitive pumps, any air in the chamber will get in the tubing. More than 2 drips we will hang them from the ceiling. Even them though because of movement in the helicopter air can get in the tubing. I think from a safety standpoint, it’s easier to miss changes in a patient’s VS or status when you are constantly trying to fix beeping pumps, you know what I mean? Thanks again.

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Specializes in CEN, Firefighter/Paramedic.
On 7/10/2022 at 1:51 PM, Stephanie Marsh said:

Hi Mike thanks so much for responding. I do not have any evidence base practice resources to cite. However, if our patient is only on 1 to 2 drips, we lay the pumps on the patient. Because of this and our very sensitive pumps, any air in the chamber will get in the tubing. More than 2 drips we will hang them from the ceiling. Even them though because of movement in the helicopter air can get in the tubing. I think from a safety standpoint, it’s easier to miss changes in a patient’s VS or status when you are constantly trying to fix beeping pumps, you know what I mean? Thanks again.

I don't have a good answer for getting air out of your drip chambers.  I've been trying to think through what is "safer" and I suppose your method is fine (rather than not confirming flow through the drip chamber observation, your pump will confirm flow).

It does seem like you're taking a step (removing air from the drip chamber) in order to save a step (not hanging your bags) so in the end I don't think you're really saving time.  On top of that, there's air in the bag, so you still haven't completely eliminated the chances of air getting into your line.

IMHO - muscle memory is important.  If you hang 2+ bags, why not hang every bag whether it's 1 drip or the balloon pump 6 runs.  Just my opinion though.

Due diligence in getting your lines set up and upstream air removed from the line before flight takes no time at all, then hang your bags, and your drip chambers can function the way they were designed.

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Specializes in CVICU/Flight Nursing.

Burp the bag! Doing so removes all the air from the bag. Could be a little time consuming so maybe not the best method for interfacility flights where you have a ton of gtts but otherwise a good method for preventing air embolus if you're bolusing by gravity or just trying to avoid incessant beeping from your IV pumps.

 

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Specializes in ICU, Trauma, CCT,Emergency, Flight, OR Nursing.

If you hang all your IV infusions , getting air in the lines should not be a problem as long as they are kept upright. We used to use IV tubing without drip chambers to reduce air getting in as well as "Burping" IV infusion bags.  What is a bit concerning though in your post is that you state you lay your pumps and infusion bags on the patient. That is not the standard of care and is a major safety issue . CAMTS standards are clear about having everything secured in the cabin for flight.  A pump lying on a patient becomes a dangerous projectile should the pilot make any sudden flight maneuvers and also could cause both you and the patient injury . It is never acceptable to have any item unsecured during flight and the FAA has very strict rules about this as well. 

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Specializes in Flight nurse.

Thank you for the incredibly condescending comment. Very helpful. I will not go further wasting your time about how these are secured or any other info on the length of our flights or other relevant information. Thanks!

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Specializes in Flight nurse.
On 7/13/2022 at 7:21 AM, TypicalCVNurse said:

Burp the bag! Doing so removes all the air from the bag. Could be a little time consuming so maybe not the best method for interfacility flights where you have a ton of gtts but otherwise a good method for preventing air embolus if you're bolusing by gravity or just trying to avoid incessant beeping from your IV pumps.

Thank you so much! This is exactly the kind of tricks I was looking for but didn’t know the “nurse term”. Our flights are short so we rarely give any fluids-unless it’s blood but that’s a whole other can of worms!  Most of our drips are super slow-heparin, pressers, sedation. Thanks so much!

 

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Specializes in CVICU/Flight Nursing.
15 hours ago, Stephanie Marsh said:

Thank you so much! This is exactly the kind of tricks I was looking for but didn’t know the “nurse term”. Our flights are short so we rarely give any fluids-unless it’s blood but that’s a whole other can of worms!  Most of our drips are super slow-heparin, pressers, sedation. Thanks so much!

NP, glad you found it helpful! Always down to share what little bit of knowledge I have haha. 

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I just hold the back upside down and squeeze prime it. Some like to hang drips and say you don’t need to do this, but I disagree for a few reasons. For one, I’ve found that hanging the drips can kind of be a pointless waste of time. A lot of people take forever straightening out the IV lines like it’s some kind of ICU, but during the transfer they get all tangled up anyway. So I typically just sit the drips in the patients lap. Lastly, even if you are one of those type A perfectionists who hang drips and make everything pretty, I’m totally fine with that, as I personally don’t care what other people prefer to do. There’s a million ways to do things. But I’ve seen it become a problem during transfer of the patient when a drip gets laid on a patients lap, or simply dropped by accident, and air enters the line. Not a great thing if they are pressors at a fast rate. So it’s worth priming them this way anyway.

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