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How often do you change clear fluids? Pressors in particular!

Posted

Specializes in NICU.

Hey everyone!

Please help. We are switching the some new pumps in our unit and it takes a little longer to switch out syringes with the new system.

My question is:

When you have drugs that such as dopamine, dobutamine, alprostadil, epi drips (basically anything with mcg/kg/min) how often to change the tubing and syringe?

We are worried our kids will bottom out too much!!!

Also, how often do you "zero" your volume to be infused?

We change drips every 72 hrs, if we think the kid will bottom out we start the drips running on a new pump for a few minutes and then change over quick

rockabye

Specializes in NICU.

We change all of our fluids/drips once a day (less chance of line infection if they get done together at once). If it is just clear fluid and only fluid hung in a particular port it will be changed on days, all others done on night shift. Usually the pressors are given a little extra push at the end before they are hung so they get to the baby quicker. Pumps are now zeroed twice a day at the end of each 12 hour shift (due to discrepancies of numbers some nurses reported at the beginning of their shifts).

Also, fluids/drips tubing are changed once a day along with the new syringes/bags. The only exception are the heparin carrier fluids or the med line if they are the only fluid running through a port; the syringe gets changed daily and the tubing is changed every 3 days.

Edited by rockabye
added more info

walkingrock, ADN

Specializes in Retired NICU. Has 42 years experience.

Pressors via syringe pump: syringe med changed every 24 hours; tubing (dedicated) changed every 72 hrs.

We change all lines/tubing only twice a week on Saturdays and Wednesdays as a part of a CABSI initiative. New syringes/bags of course must be put up every day. For the extremely fragile baby on pressors, you can make a whole new set of fluids and meds in their tubings on a different set of pumps, get them running and then just do a quick switch of everything down at the clave. Then disconnect and discard all the old stuff and take away pumps. This gives the baby basically NO time without his/her pressors or prostin or epi or whatever.

We zero all fluids on pumps at midnight each night.

NeoNurseTX, RN

Specializes in NICU Level III.

Every 24 hrs, total line/fluid change. If the baby is only on clears, day shift does it, if it's anything running with TPN, nights does it. Art line fluids changed q24 but the tubing and tranducer is every 3 days. All PICC/central lines done sterile by a line team and PIV done by bedside nurse.

SteveNNP, MSN, NP

Specializes in Neonatal ICU (Cardiothoracic). Has 9 years experience.

My unit has had two policy changes on fluid line changes in the past 2-3 years. It's maddening for the nurses.

We change all our medlines, TPN and IL q 24h. When I was staff, I used to prime my drips on our medfusion syringe pump, and my fluids on our Sigma pumps, and have them all running as I disconnected the old line at the q-site, and reconnected the new.

Priming it on the pump, instead of by hand eliminates any deadspace between the motorized arm and the plunger on the syringe, which prevents any delay of fluids moving forward through the line, especially on pressors running at hundreths of a cc/hr sometimes...