What did I do? Blood in IV tubing!

[Hockeynursing]

Hi there,

I am looking for reassurance and guidance.

i had a patient today who had an IV infusing on a pump. The IV ran dry and needed a new bag so the pump was beeping.

i thought I knew what to do so I grabbed a 10 cc syringe and attached it to lowest port, clamped at patients side to ensure I wouldn't draw his blood. I had huge resistance when pulling (I realize now this was because I hadn't changed he bag yet so was pulling from an empty bag)

what happens next requires explanation..

at that point, I let go and immediately blood started climbing the line a foot up tubing.

i disconnected tubing, flushed IV and primed and attached new tubing.

did this happen because pressure was more in his vein? Because I took air out of bag?

any harm to patient? He seems totally fine!

next time I will disconnect and run it through! Or attach new bag first!

thanks so much I am very worried. I fear air got into him some how but I don't know how that would have happened

[psu_213, BSN, RN]

NotAllWhoWandeRN said:

When you create negative pressure by pulling back on a locked line then opening the line at the patient end, yes, it makes sense to me.

I think what he was saying is that even if the pt. has high BP (i.e. high arterial pressure) this does not translate to any higher pressures in the vein. If blood backed up, it has to do with the negative pressure created by pulling back on the IV tubing.

To the OP, the pt. is fine. Blood backing up into the tubing just means the catheter is in the vein. In the future, however, ask an experienced nurse whenever you have these "what is going on?" moments.

[RescueNinjaKy]

ICUman said:

Venous blood pressure has that much exertion, to travel a foot up a tubing set?

My apologies, you caught me exaggerating.

[paidmydues]

Oh my what a mess! No harm to pt, but scary for new nurse who has to run and get fresh fluids and new tubing real quickly. Have flushes and alcohol wipes in your pocket for times like these. Make sure line is flushed and saline locked nicely. Then you can take your time getting fresh tubing and another bag of fluids. Better yet I agree with poster above and set pump leaving 100 in bag. When it beeps I will have lots of time to fetch a fresh bag of fluids. On nights, I will sometimes change a bag of fluids early (wasting as much as 200ml) if, when doing my initial assessment at 2300, I don't want my sleep deprived pt to be woken out of a sound sleep by the pump beeping and me hustling around the room. I never let my IV bags run dry. NOW, how can we fix those pesky PM shift nurses who leave you 3 bad IV'S to restart at midnight???? Good luck!