Primary IV Pump

[Blueorchid, ASN, RN]

Alright- so I know this skill would likely never happen in real life. But today during my validation I had to start a primary IV line through a pump. Our school only has 3 IV pumps to use thus we have only 3 sets of tubing that can be programmed into said pumps.

And by this point, they've been used and used over and over again so the tubing is full of bubbles. I spiked the IV like normal and was instructed in order to prime the line I would need to open the tubing to let the air bubbles drain out. Normally we're taught to do this in a trashcan until we're sure there are no bubbles. There was no trashcan so I thought alright, I'll let the tubing flow and made sure the clamp was uphill with the cap on. There was no movement there either. Now I know in a normal situation I would not have been using old tubing like this but, with air in the line when I turned on the pump its not going to go through.

I went so far as to even try gravity to prime the pump like the secondary IV piggyback where you hold it low and then hang it high. Nothing again. In verbalizing that I wouldn't have this situation I think I covered myself but does anyone know if there's anything else I could have done? And is it logical that when I attached the tubing with the clamp uphill nothing happened? I'm rather bothered by this...

[Daytonite, BSN, RN]

Open all clamps, clear everyone from the area and then whip the tubing through the air. Centrifugal force will do the rest. Another thing you can do open all the clamps and, starting from the top and working toward its end, just keep wrapping the tubing around something putting as much tension on it as you can on it to get the fluid to come through (this is called milking it - we do something smilar with chest tubes). Milking is probably safer than whipping the tubing around. Someone could get hit with the tubing and if you are waving it fast enough they could get hurt. A third option is to load a large syringe with IV fluid and push it through the highest Y-connector. Always remember, air is lighter than water, so it tends to float upward. When possible, position the tubing up so the bubbles have no other option but to go up which really is forward toward the downward end of the tubing.

[Blueorchid, ASN, RN]

Like a chest tube...hmmm. I think I've also seen something similar with a suction catheter for a trach tubes. We haven't gone over that skill yet but thanks for the information! I guess you never know what you'll come across so its good to know how to handle everything.