hanging IV bags w/ the pump

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Ok--so I'm in nursing school, im in my 3rd semester of clinical rotations and I haven't had many opportunities to hang IV bags and piggybacks until today and boy was I clueless...and of course my instructor doesn't seem like she's doing it right either...

for example, here's what happened at clinical just the other day...

i'm about to hang a piggyback, and I've only done this during lab at school, never in the clinical setting, so i'm nervous as hell...anyhow, she guides me through it, but kinda pushes me outta the way too because I guess she's in a hurry, whatever...but I saw her take the piggyback line, and unscrew the blue cap and it appeared to dump some medication into the trash, (I'm assuming she was doing this to get the air out--hello, don't we backflush??)

OK, so basically all I need to hear is the simple dirty steps to go about hanging IV's and piggyback, (With the pump) any feedback would be much appreciated..!! thanks

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I rarely see people backflush. Usually I and others prime the secondary by slowly running the fluid through. You should only lose a drop or two.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

your instructor didn't do anything wrong. can you point out how she broke asepsis in any way? she didn't. your instructor's gruff behavior isn't an excuse for yours here on your post. your bruised ego will heal. keep your eye on the ball here--learn how to do this procedure rather than shooting bullets at your instructor--so next time you can dazzle her with how you've learned and improved. ;) here are links to a video and a couple of pictorials on how to spike and hang piggyback meds.

http://www.cotc.edu/professional/streaming/archive/nursing.htm - streaming videos from central ohio technical college - click on "intravenous medication administration - piggy back". will need a real one player to see the video.

http://flightline.highline.edu/drydberg/balckboard/intravenous_piggy_back.htm - how to give an iv piggyback med. includes a picture of how the ivpb is set up onto the mainline of an iv.

http://flightline.highline.edu/drydberg/balckboard/spiking_the_iv_bag.htm - how to spike the piggyback bag and hang it. photos.

http://teach.lanecc.edu/nursingskills/ - lane community college skills page - you will find links here to iv procedures

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Specializes in SICU.

I don't think she had a bruised ego. In our school we have to hang piggybacks using backflow. We are not allowed to flush through. If this is the same in her school, then the teacher did do something wrong. The teacher then did not follow correct procedure even if she used one that is used in most hospitals.

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Specializes in Utilization Management.

We backflush--if it's a compatible fluid. ;)

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I'm a backflusher all the way!! Way tooooo often we follow a nurse that primed the IVPB line, hung it, programed the pump, then .... forgot the unclamp. If you backflush, you will always be ready to roll with an open line. And for the times we have to prime the line, let's say for primary tubing of maintenance fluids, sometimes you DO have to run quite a bit of fluid through to get ALL those pesky air-pockets out. Both ways are acceptable ... you should just go with works BEST for you!

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I'm a backflusher all the way!! Way tooooo often we follow a nurse that primed the IVPB line, hung it, programed the pump, then .... forgot the unclamp. If you backflush, you will always be ready to roll with an open line. And for the times we have to prime the line, let's say for primary tubing of maintenance fluids, sometimes you DO have to run quite a bit of fluid through to get ALL those pesky air-pockets out. Both ways are acceptable ... you should just go with works BEST for you!

Me, too! We used to have very sensitive pumps and if the piggy back was going into simply "primed" tubing above the pump we'd always get an alarm for air that we couldn't see. I think it was a problem with the blunt plastic access devices? Back priming solved that. Besides it's the way to go when you're hanging a replacement piggy back bag onto existing tubing, just change the bag and do not need to unhook any tubing and reaccess. I agree that that's the best way to keep me on my toes and not hang a clamped bag, too!

That said... if your instructor, primary, or preceptor wants you to do it a different way... sigh... learn the different way and keep mental tabs on everybody you work with and their preferance. The general rule of nursing school and orientaion, unfortunately!

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Specializes in cardiac/critical care/ informatics.

I think either way is acceptable backflushing allows you to lose less fluid and does keep you from forgetting to unclamp the piggy which is so easy to do.

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I make it a rule of thumb after hanging all bags, piggybacks or primary bags-- to stay in the room for a few seconds after hanging the bags and see the drip and listen for any pesky beeps the IMed is making (unroll the clamp, air in line, occluded on patient side). And please get in the habit of labelling your tubing. I am distressed when I come into a new patient's room and no labels are on the tubing.

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