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Running the pump dry

Medications   (825 Views | 4 Replies)

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TL;Dr

Is it okay to not run the pump dry?

So I work in an ICU and a number of people have complained about pumps being run dry. 

For newbies like me who don't know; Running a pump dry is using up all the volume in a hung medication.

Opposed to leaving just the right amount of in the drip chamber/tubing so you don't have to prime the tubing when you hang the medication again. You just spike the new bag with the old tubing and hop to it.

I get it in continuous medications (duh)

What about other medications? Isn't there 20 cc of medication in the drip chamber/tubing that you aren't giving each time you stop a med short? Is it somehow okay to not run medications dry?

I only ask because the experienced nurses are the ones not running the pump dry and they probably know something I don't. I didn't ask yesterday because dude seemed genuinely pissed and I was trying my best not to drown.

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JPnewACNP has 5 years experience as a BSN and specializes in Intensive Care/AG-ACNP Student.

22 Posts; 1,212 Profile Views

Honestly, this usually isn’t a big deal and I don’t run anything dry unless I’m there with another bag. For continuous drips, I leave myself about an hour or so of volume to remind me to get another bag. For intermittents, I do 5ml less than the total volume because on some pumps it’s a pain to get air out of the main line and shouldn’t make much of a difference to the pt. Use discretion though, somethings (tpa, amio bolus, etc) I prefer to run it dry. 

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MunoRN has 10 years experience as a RN and specializes in Critical Care.

4 Followers; 6,611 Posts; 68,575 Profile Views

Using a primary / secondary set-up would be a better way of making sure the patient is getting the full dose, if that is your concern.

In my experience, running the tubing dry to the pump if the there will be subsequent infusions through that tubing is generally considered to be a severe nursing sin and is adequate reason for nurse-on-nurse homicide, so I would avoid it if possible even if you don't see the big deal with it.

If your concern is making sure the patient gets the full dose, then it wouldn't make sense to run the infusion dry to the pump since then next person will have to re-prime the tubing to clear that air which will waste far more of the medication than you will have infused by running it dry to the pump.  At least after the first infusion through that tubing the line will be primed and the patient will get the full dose, so long as you don't run it dry.  But again, a primary / secondary set-up would be the preferred way to ensure the patient gets the full dose with each infusion.

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HappyCCRN1 has 6 years experience as a BSN and specializes in Burn and Surgical/Trauma ICU.

56 Posts; 749 Profile Views

Agree with the above. If you are giving an antibiotic or electrolyte replacement, etc., they need the whole bag. Use a secondary in this situation. I see infusing those medications with a primary set instead of a secondary as a nursing sin—it drives me crazy. 

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TheLastUnicorn has 4 years experience and specializes in Critical Care, ICU, Rehab.

37 Posts; 113 Profile Views

Depending on the pumps used, it really doesn't matter. I've used pumps with a back prime feature, so you can hook up a 250 of NSS and use that to back prime the secondary tubing and hang a new bag. I've also had pumps with out that feature, that have only a secondary option and learned that when you unclamp the secondary while the primary is running, it will back flow up the secondary line, essentially back priming it when you unspike the old bag (be ready to clamp quickly). Spike the new one and good to go. 

Also, depending on the medication and the pharmacist; most our IV meds have an extra amount of fluid to prime the line with. 

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