Labeling IV bags, bandages

mcdonaldgirl · Apr 3, 2006

what do you usually have to label on the iv bags when you hang them?
i remember (correct me if i'm wrong) iv bags are:
-date hanged
-time hanged
-amount started
-cc/hr
-i also semi-remember being told my a clinical professor to write down what the amount should be at 1 hour after you hung it.
bandages (ie. tape when iv is started)
-date
-time
-your initials

i was taught the same thing. also, if the iv bag doesn't have that strip that goes down the side of the bag, i was told to use the cloth tape with pertinant info. listed on it.

"mac"

Daytonite, BSN, RN · Apr 4, 2006

Every IV bag should have the date and time of day that it was spiked and hung on the patient. A bag should never hang longer than 24 hours. If anything has been added to what the manufacturer put in the bag you also need to mark the date, time of day, name of the additive, the amount of the additive and the name and signature of the person who added this medication to the bag and this needs to be clearly attached to the bag. Each bag should also indicate the ordered flow rate. This can be done a number of ways. If there is a pharmacy label attached to the bag, this information may be included on that label. Otherwise, what we typically did in the days before the pharmacy labeled all our IV fluids was to take a piece of tape (we used paper, plastic or cloth--whatever happened to be in our pocket, guys) and place it along the measurement markings of the IV bags before spiking them. Using a pen or Sharpie marker we ticked off the hourly measurements. Those of us who did this years ago were very good at it. Obviously, 100cc an hour is the easier to do a time-strip for. 80cc or 60cc an hour is a little bit more of a challenge. You also need to remember that there is 50 to 75cc of overfill in the bags so if you started your time strip where the manufacturer prints the measurements on the plastic bag, when you turn the bag upside down to spike it, your bag is going to indicate that it is behind before you even started to infuse it. So, after time-stripping the piece of tape, we repositioned it so that the first tick mark, which was the starting time of the bag, was placed at the fluid level when the bag was first hung on the IV pole. This gives a more accurate eyeball look at where your bag of fluids is in relation to being ahead or behind in it's rate of infusion. I always put the date, time and infusion rate at the very top of that time strip along with my initials on every IV bag I hung even if the IV was placed on an IV pump.

VickyRN, MSN, DNP, RN · Apr 4, 2006

Other essential tips:

NEVER write directly on the IV bag - the ink will seep through into the fluid.

NEVER use an IV bag that someone else has opened. You never know what medication has been added to the bag. Violation of this basic principle resulted in a tragic patient death in our area about 10 years ago.

Mr.Sandman · May 15, 2012

Does Anyone know of a scientific study that has been done to independently verify this claim of "leeching"? Inquiring minds really want to know!!!!

loriangel14, RN · May 15, 2012

We have labels that are for the IV bags.You just fill in all the spaces with the required information.We also have to label SC ports with what it is primed with.

NCRNMDM, ASN, RN · May 16, 2012

I've heard that you should never write directly on an IV bag with a Sharpie because it bleeds through (I don't know if this is true). I always write on an IV bag label, or I write on tape. I include the time the bag was hung, the rate of infusion in ml/hr, my initials, and the date. If there is medication in the bag, I include the drug, the concentration in mg/ml or mcg/ml, the rate of infusion, and the date and time.

For lines, I write my initials, the date and time the line was initiated, and the gauge of the IV (I know you can look at the hub and tell, but it's easier to label it).

Asystole RN · May 16, 2012

One should use a proper label to label an IV bag for two reasons; first it is simply the professional thing to do (looks professional), and second a label provides a uniform medium to distribute important information. You want everyone to instantly recognize the label, be able to identify the information upon that label, and identify what information may be missing.

That being said, the idea that Sharpie markers bleed through IV bags is an old wives tale dating back to the days when IV bags were primarily constructed of polyvinyl chloride, which is semi permeable by the way. Most IV bags are constructed of newer non-leaching materials such as polypropylene. Keep in mind that Sharpie markers are typically (does depend on the season, location, and type) alcohol based.

Do use a standardized label because it is professional and safe, not because of some myth that has little to no basis in fact.

classicdame, MSN, EdD · May 18, 2012

we no longer write on them. THe info is in Pyxis and MAR

Mr.Sandman · May 19, 2012

Thank You Asystole RN. I still thought the bags were constructed of PVC. Do you have any idea if the new bags are more porous if heated such as in a warmer?

Finally, do you know of any evidenced based study in regards to writing on an IV bag of fluids with a permanent marker?

Asystole RN · May 19, 2012

Thank You Asystole RN. I still thought the bags were constructed of PVC. Do you have any idea if the new bags are more porous if heated such as in a warmer?
Finally, do you know of any evidenced based study in regards to writing on an IV bag of fluids with a permanent marker?

Pretty much all polymers become more permeable when you increase the thermal radiation they are exposed to. The degree of that permeation varies significantly depending on factors like additives, polymer orientation, humidity, etc.

Warmers marginally increase the temperature of the material, we're talking a warming of between 85-95 degrees Fahrenheit. I would hypothesize that a fluid warmer would have a negligible affect upon permeation.

I have never seen nor heard of a study examining the possibility of permeation of permanent marker ink through polypropylene or polyvinyl chloride. I know for a fact that there are no studies along those lines in JAVA or JIN.

Mr.Sandman · May 19, 2012

Asystole RN, you have been very helpful. I am a MSN student & for my research project I plan to do a benchmark study on this subject. My research director knows of a study done on blood product bags but not IV fluids. I am just getting started & still in the discovery phase of my research but when I have an answer to my hypothesis, I will post it here for all to see.

Again Thank You very much!