IVs - pause pump or clamp first to remove?

[Gymah]

What is the correct order for attaching/ starting a new IV line/ tubing, and for removing/ replacing existing tubing? I've heard that the incorrect order can cause the veins to collapse (particularly on fragile veins or pediatric patients). 

Do you pause/ unpause the pump first? Or the roller clamp? Or the clamp closest to the patient? 

[Nurse Alexa, MSN, RN]

The correct way in which I was taught - 

Ending an infusion:

1. Stop the infusion on the pump 

2. Disconnect from the patient, alcohol swab, flush with 10 mls and cap the IV.

3. Disconnect the tubing from the IV and dispose of accordingly.

 

New Infusion:

1. Flush the medication completely through the tubing without any bubbles, clamp the line.

2. Follow the guidelines for the pump

in your facility. For the Alaris, it tells you which part of the tubing to place in the cartridge first (place top piece in first, followed by the cassette looking piece with the white part out).

*Key is to keep the white part of the cassette out. So many times I have seen nurses keep it open - which can lead to free flowing of the medication to the patient.

3. Once the cartridge is set - close it. Unclamp the roller clamp on the IV tubing, put in the correct Med, concentration and rate then start the infusion. 
 

hope these tidbits help xx