Forgetting to prime peripheral IV line...

[lpnmommy86]

Hi All! I have been dealing with this in my head all night!! I've searched the internet, but would like your input. If you forget to prime a peripheral IV line that infuse by gravity on a child, what would happen? Severe coughing? Would the child be ok? Any insight will be greatly appreciated.

[Julius Seizure]

I doubt any nurse who works ER/ICU etc. can claim this has never happened to them, and therefore you should always take advantage of something that will catch that mistake for you (a pump).

Can confirm: Pump caught my mistake on this not even two months ago.

[trinitymaster]

Buretrol (at least) always and only enough fluid to last for one hour at the most. Last time I did little PEDS was 12 years ago.

Mistakes happen and I am not one to judge. That said.....if it were my child, then you would be in front of the board.

Please be more careful.

[trinitymaster]

This is one reason why I never like to run anything outside of a pump, particularly on kids. There are a couple of things the OP can learn from this; it's certainly possible to start an infusion without realizing the line wasn't primed (I doubt any nurse who works ER/ICU etc. can claim this has never happened to them, and therefore you should always take advantage of something that will catch that mistake for you (a pump).

I make a puddle even when I use a pump. PFO (my son's mom has one) plus big bubbles does not a good combination make.

[anon456, BSN, RN]

I have heard of this seriously harming a child. I also make a "puddle". I prime the line and drip the extra into the empty IV tubing bag.

[Julius Seizure]

Better than a puddle - when possible, use a filter on the end of your tubing, at least for kids with PFOs/heart defects.

[Lunah, MSN, RN]

I have heard of this seriously harming a child. I also make a "puddle". I prime the line and drip the extra into the empty IV tubing bag.

Yep, I do the same thing. :)

[Anna Flaxis, BSN, RN]

This is one reason why I never like to run anything outside of a pump, particularly on kids. There are a couple of things the OP can learn from this; it's certainly possible to start an infusion without realizing the line wasn't primed (I doubt any nurse who works ER/ICU etc. can claim this has never happened to them, and therefore you should always take advantage of something that will catch that mistake for you (a pump).

Actually, I can honestly say this has never happened to me. I almost even hate to put it out there, like I'm tempting fate now and will be rewarded for my foolishness by having this exact thing happen! I didn't used to be superstitious, and in most of my life I am not, but ever since starting to work in the ED, I have a heightened sense of how uttering the wrong words can manifest consequences by some mysterious mechanism that I can only attribute to ED Karma.

Anyway, no I have never forgotten to prime a line. I realize you are probably trying to be supportive of the OP by saying it's a mistake anyone could make- which is true. When things are happening quickly and you are distracted, stuff like this can happen. It's why we need to slow down and double and triple check- even in an emergent situation- and never run anything on a kid without a pump.

[Julius Seizure]

I didn't used to be superstitious, and in most of my life I am not, but ever since starting to work in the ED.

Same here! I am not superstitious at all and I don't really believe in mystical-type things.

But ever since becoming an ICU nurse, I am totally sold on the belief that things come in threes and that there is just something about a full moon. :)

[nurse2033, MSN, RN]

You can bet it was a lesson learned. I was/am mortified. I will not forget it ever again. Dr was called to the room when this happened. I was not sure what happened at the time. This is the only conclusion I can come too. It was an incident of distraction as well. HR and SpO2 was great. Breathing treatment was done. JustaGypsy thank you for the hug! Definitely needed after that!!!!

Thank you for adding this. We work in a minefield which is what makes us awesome. It just shows the vital importance of developing good habits, I'm glad this turned out OK. :)

[lpnmommy86]

Everyone can rest assured that this nurse will not run anything on a peds pt without a pump ever again. And I usually run around 30ml in the iv tubing bag to make sure bubbles are out. I am a new ED nurse, so any other tips would be GREATLY appreciated.

[Mavrick, BSN, RN]

Thank you for adding this. We work in a minefield which is what makes us awesome. It just shows the vital importance of developing good habits, I'm glad this turned out OK. :)

Whatever OCD you have, put it to good use in developing those habits that you just ALWAYS do. And don't forget to wash your hands!

[IVRUS, BSN, RN]

Everyone can rest assured that this nurse will not run anything on a peds pt without a pump ever again. And I usually run around 30ml in the iv tubing bag to make sure bubbles are out. I am a new ED nurse, so any other tips would be GREATLY appreciated.

As other posts have said, most IV tubing holds between 15-25 cc. Some more, some less... but your goal should NOT be to run 30cc through to ensure all bubbles are out. Think about it this way, you have a tubing which holds 15 cc, and your bag of IVAB is 50 cc... If you run 30cc out of the tubing, you are seriously dumping most of the antibiotic in the trash. What your goal should be is to spike the IV bag with the IV tubing, fill 1/3 of the drip chamber by squeezing it, then SLOWLY allow the fluid to purge the IV tubing all-the-while keeping an eye on the fluid level as it runs through the tubing. This way, once it hits the end of the tubing you can promptly close the clamp and never loose a single drop of this precious fluid.