I'm a new grad working in the NICU, and my preceptor keeps telling me that I'm too obsessed with clearing air bubbles from my IV tubing, especially when hanging TPN. She tells me that it would take a couple inches of air in the IV tubing to cause any harm, but I just cannot get out of the habit of trying to clear all the air bubbles. Consequently, it can take me forever to hang my TPN!! When I worked with another preceptor, she seemed to be a little more concerned with air bubbles, and so I think that is where part of my obsession comes with. So, I wanted to hear everyone else's opinions on air bubbles in IV lines, how much air or how big of bubbles are acceptable, and any tips and tricks you have for clearing them or preventing them in the first place!! And I know it also depends on the type of IV...PIV, PICC, art line, ect. Am I being too obsessive!??
Remember that air flows UP. When you get to your hubs, turn them upside down so with fluid fills them. I usually hit them on the table to knock the air out. Same with filters, except I don't hit them, that makes it worse. Prime the tubing slowly. Adjust your roller clamp to slow your flow down. That is what I did at first. I've done it enough now that I usually don't slow it down. Our lipids are run with our TPN, so we put a filter on it.
On our pumps, anything above the part that goes into the pump I'm not super concerned about. When I shut the pump, the air is pushed into the bag.
Lately I've been so nervous about air bubbles! I'm not sure if it's just that I'm noticing them a lot more now than when I started out but they can be pretty scary. I am less worried with the PIV but mainly my UVC and especially my UAC. Our UAC's are only used for blood draws and bp monitoring. When I draw blood from my UAC we need to draw back the blood past the access port so you get a fresh sample free of a-line fluid. When I am finished and go to flush the line to clear it, I can see a small gap of air in the tubing past the access port that luckily is caught in the trap before it gets to the baby but I always worry that it won't trap and will go into the baby. What do you do if it makes it past the trap? pull back on the syringe and try again? Any thoughts?
Remember this is arterial. First...close all your ports to the baby, tap the air to the top, fill with flush and go ahead, Be Calm., open the ports when you are 1000000% sure! Take your time, it's not a race, it's a life. You will get there, just have faith!
Preemienurse23
214 Posts
Remember that air flows UP. When you get to your hubs, turn them upside down so with fluid fills them. I usually hit them on the table to knock the air out. Same with filters, except I don't hit them, that makes it worse. Prime the tubing slowly. Adjust your roller clamp to slow your flow down. That is what I did at first. I've done it enough now that I usually don't slow it down. Our lipids are run with our TPN, so we put a filter on it.
On our pumps, anything above the part that goes into the pump I'm not super concerned about. When I shut the pump, the air is pushed into the bag.