Question about iv fluids

Editorial Team / Admin · Nov 8, 2014

Drips going into the drip chamber means that there is somewhere for the fluid to go. Could it be the patient's vein? Sure, but it could also be through a hole in the tubing. Best practice would be to check the tubing and the clamps to ensure that the system is working properly. I myself, working in the OR where arm boards are placed on the table after the patient is moved over, have managed to pinch IV tubing between the clamp and the table. The IV drip chamber looked like the patient had a great vein, but in actuality the fluids/meds were never getting to the patient as they were dripping all over the floor instead. Remember what happens when you assume: you make an ass out of u and me. Never assume that just because something looks like it's working the way it should means it really is.

wanderlustnurse88, RN · Nov 8, 2014

In theory that should make sense but pts don't always follow theory. Had one pt who ripped out his IV and the pump was still running it all onto the floor. Didn't realize it earlier since the pump wasn't beeping at me.

iPink, BSN, RN · Nov 8, 2014

If the clamp is not open the pump should beep, with an error message. Depending on the pump. You can adjust the drips by adjusting the clamp. If the system detects an occlusion, it will let you know. You'll check the clamp, patient, and tubing.

Now if the IV comes out and is dripping on the floor, the pump will still be running because there's no occlusion. That's why we can't rely 100% on the machine and do our do diligence and make sure everything is fine before leaving the room. Of course things can fall apart after you leave.

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Cook23 · Nov 8, 2014

Thank you all for your answers ! I too did not agree with their way of thinking I prefer to check everything that needs checking before assuming. So from what I realize if it's dripping it means that the tubing is indeed working all the way to the vein or there is an abnormal opening to it. Does that mean that the dripping will stop if the tubing is somewhere clamped on its way to the needle ?

Cook23 · Nov 8, 2014

Same thing for stopcocks, if a stopcock is blocking would there be any drops ?

akulahawkRN, ADN, RN, EMT-P · Nov 9, 2014

If the fluid path is blocked, then there will be no path for the fluid, no flow will happen. Therefore, no drops will fall. Open the stopcock so that the fluid path is not blocked and goes somewhere (like floor or patient's vein) then you'll see drops dropping in the chamber...

It's all about the water column...

Cook23 · Nov 9, 2014

Thank you all so much for your answers, they really helped me a lot !

IVRUS, BSN, RN · Nov 10, 2014

Hi ! I wanted to ask a question about iv fluids. If the fluid is dripping into the drip chamber and I can see the drops flowing from the bag into the chamber, does it mean the tubing is open all the way to the vein ? I was discussing it with my fellow students the other day and one of them told me that if I see the drops from the bag into the drip chamber I don't have to check the clamps to see if they are open or not. Is it true ? Is looking for drops in the drip chamber enough to know that the tubing is open all the way from the bag to the needle ?

Never allow the medication infusing into the drip chamber, take the place of doing a complete site assessment. As others said, it could be dripping into the chamber just fine, but then a site assessment shows an area of infiltration/ extravasation depending on the medication. So, just looking at the bag and drip chamber doesn't give you a complete picture. Or, it could be dripping fine, but then assessments reveal that it has become dissconnected from the IV catheter and their bed/floor is full of the solution/medication. That is one reason why each time you assess, it should be the entire pathway into a patient's vein. That will determine whether or not it is patent. So, once you've flushed with NSS and assessed patency, hook up your medication/solution and then observe it flow.

OBigdog26, MSN, RN, NP · Nov 10, 2014

C'mon now, use some critical thinking!

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StudentOfHealing · Nov 10, 2014

It only takes a few seconds to check everything. You have to check your IV insertion site anyway. By the way, there is no needle - the needle is removed and what's left is the plastic catheter you thread.

=)