how long can you prime fluids for in advance of infusion?

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I'm working in a level III Nicu. The question the nurses all have is how far in advance of connecting and beginning the new TPN/IL infusion can you prime the fluids?

Is there a higher risk for infection with a line primed in advance?

It seems that one the one hand if there sterile technique were perfect and the line was never at risk of being contaminated it could be primed anytime in advance, hours or ?days. But, if being on a counter on a sterile drape and also under a sterile drape, there could be accidental contamination- there could be theoretical risk for infection.

Which brings me to another question. If there is no difference in priming immediately prior or hours before, then how come it isn't done?

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Because TPN doesnt seem to come up from pharmacy until 530-630! :rotfl:

Anyways I'm sure there is an actual reason as far as how long the components are "good" for as well, and I would guess all the elements shouldnt just be sitting in tubing w/o running, maybe it could stick/clog or something

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Specializes in NICU, PICU, educator.

We just prime and hang. We will sometimes prime and not hang if we have a kid on the window. As long as your end is not contaminated it should be fine. Just make sure to swab down your connections well. And it would only be sterile under a drape if you stood guard over it and made sure no one bothered.

As for days...TPN is only good for 24 hours usually, so that is a moot point. Priming and hanging is just best clinical practice for the most part, less risk of contamination.

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Specializes in NICU Level III.

I don't understand why you would prime everything then just let it sit there?? Why not just hang it?

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The TPN/IL is off for four hours every day to give the patient's liver a holiday.

So the TPN/IL come at let's say 5 pm and then the new infusion begins at let's say 9 pm. Some nurses prime and leave it at the bedside for a few hours with a cap on the end. I like to prime it no more than an hour before because it seems right to me for all risks, both real and theoretical, it is safer. There doesn't seem to be any research or protocol out there however so I am asking all of you. :D

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Specializes in NICU, PICU, PACU.

With the kids on windows, we will prime it and reconnect to the line, just with the line clamped off. I've seen it primed and hung at the bedside, but as long as the connections are appropriately swabbed before connecting them, it should be okay. But best practice is to prime, connect and have a closed system.

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Specializes in L/D 4 yrs & Level 3 NICU 22 yrs.

I find it interesting, in reading this thread, that you turn off IVF for 4 hours. I have not heard of this practice. What about hypoglycemia? What do you do about concurrently infusing drips like dopamine or fentanyl? Are the fluids turned off at the same time for all babies? Very interesting!

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Specializes in NICU, PICU, educator.

We window the TPN for a certain amount of hours to give the liver a break. We use it on our short gut kids especially, since they are on long term TPN and their LFT's are awful. You don't start them right out on a long window, you taper down the fluids over a certain amount of time and start with a one hour window, check glucoses as ordered. We do this for 2 to 3 days and if they tolerate the one hour, we go to two hour, then three hour and then four hour. It is only the TPN/IL that is turned off. And if a kid is on pressors, they are too sick to handle a window at all. We leave sedation gtts running. Some places will run 1/2 saline during the window if they are worried about it clotting off.

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Hi

Just prime the fluid closing the tip with a needle set and then prime faster then connect to the patient. It woudlbe always sterile.

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