IV lines

[Elena88]

Question for experienced nurses...do you have tips and tricks for stopping backflow of blood into the line or the bag of fluids when the fluids don't need to be run under pressure?

Especially if the line has to be disconnected for patient to get up or for administering something else in between. I did this and the blood in the IV line made its way back to the bag so we had to change the whole bag of fluids. Also is it correct to change the bag if there's some blood in it from the patient's own cannula?

[iluvivt, BSN, RN]

Could have been in an artery if it backed up all the way into the bag and the bag was at least 3 feet above the level of the heart

[Kareegasee, RN]

I don't understand this at all. I've never had it happen. I would change the bag for sure though, since blood tubing according to most policies needs to be changed within 4 hours. Plus it's sloppy and the families will start analyzing everything you do.

[Guest219794]

This is the UK, some of our HCAs (healthcare assistants) can have training for cannulation although they don't normally put up IV fluids or flush lines so I'm not sure if this HCA did that with supervision from someone else.

The line was clamped and disconnected from the cannula so the patient could go to the toilet (young fit person with stable vitals). This is in the emergency department. I clamped the line, disconnected with a small backflow from the cannula into the line. Then before I had the chance to see the patient after he returned from the toilet to reconnect his fluids, I was told the bag had blood in it so she changed the whole thing. I just can't understand how the blood could have gone past the fully shut clamp to get into the bag.

On a separate note, maybe in this case it would have been better to flush the line via the line flush port, then clamp then disconnect?

The bag was not lower than the patient, it was on the IV hanger attachment behind and above his bed and his cannula was antecubital fossa

this is the giving set used: Baxter IV Fluid Giving Set - Supplied singly or in boxes of 1

I think you and the HCA had a communication problem. Blood did not travel up a clamped line into the bag. Just because you were told that it did, does not mean it happened. The unly way that blood would have gone from the cannula end of a disconnected line up into a bag of fluid would be to invert the bag, raise the line, and un clamp it. The PCA misunderstood, or mis spoke.

Regarding what to do about the backflow of blood into the line? Generally running the line wide open for a few seconds will do it. IF not, then, sure, flush via an access point.

[Elena88]

Yeah I think she saw blood in the line and thought the whole thing had to be changed. I just wondered if I was missing something! Cannula was definitely not in an artery. Thanks for the advice guys

[AnnieOaklyRN, BSN, RN, EMT-P]

1) I would make sure the line wasn't accidentally placed in an artery if the blood is back flowing even with the clamp shut down.

2) As others have posted keeping the bag as high as possible and clamped will help, you can also close the clamp on the lock itself and that will help also.

Annie