Why is this so? Misunderstand the concept for IV Bag Infusion

2ndCareerRN · Aug 11, 2005

I usually put in a number that equates to 10-15 minutes before the fluid infusion is done. That way, if I am busy, the pump beeping will cue me to change the bag. That way there is not a period of time that the fluid is not infusing.

Others may do it for other reasons.

bob

Marie_LPN, RN, LPN, RN · Aug 11, 2005

I usually put in a number that equates to 10-15 minutes before the fluid infusion is done. That way, if I am busy, the pump beeping will cue me to change the bag. That way there is not a period of time that the fluid is not infusing.

Same reason i do it.

pricklypear · Aug 11, 2005

Me, too. Plus, not all bags have exactly the stated amount in them, especially pharmacy mixed bags. Setting the amount slightly lower does ensure that you don't have to hassle with air if the bag runs dry prematurely.

allnurses Guide · Aug 12, 2005

I alway put 998 ml in . . . . for the same reason . . .

steph

XIGRIS · Aug 12, 2005

Hi Again

I was wondering as to why it is when infusing for example Normal Saline 1000ml that some nurses prefer to input into the controls on infusion pump much less ie 900ml. I did hear something about air in line. How can this be so when priming the lines is to remove air and how can air come back?

looking forward to your explanation on this, as I am baffled

I guess the reson why we do this is to alert us that we need the change the bag and if you happen to be busy, you have approximately 100 cc left in the bag.

The good thing about infusion pump is there is an alarm system that tells you if air is in the line so air is not really the issue.

Another "trick" I do is when I change any pressure bag ( ex. A-li and PA line ) I use an 18 gauze needle to decompresser the bag and get rid of the air, in so doing when bag is empty the 300mmHG pressure is not going to flush the air into the patient.

MissJoRN, RN · Aug 12, 2005

Hi Again
I was wondering as to why it is when infusing for example Normal Saline 1000ml that some nurses prefer to input into the controls on infusion pump much less ie 900ml. I did hear something about air in line. How can this be so when priming the lines is to remove air and how can air come back?
looking forward to your explanation on this, as I am baffled

I agree with everyone else's rationale for time- I like a warning before my bag needs to be changed NOW, then, if I'm in the middle of something I can just add more time to the pump and chage the bag when I'm done with my priority.

To try to explain your air question, that is also a concern, I have had that happen and it's a PITA. When you prime the tubing you do push the air from the tube but you don't create a vacuum, there is still plenty of air left in the bag. Picture if you took a primed IV bag hung it on a pole (over a trash can, please) and just opened it up to drain all the water. 1000 cc later the last of the fluid would be dripping out of the end of the tubing leaving you with a bag and tube set filled with nothing but...air. Your pump will alarm to tell you when that starts to happen, no air will reach the pt but you will now have to get all that air out before you start your new bag. You can do this with a syringe at the port below the air. I do it by gravity, some will aspirate the syringe, either way it's not easy for me to describe, ask someone to show you their favourite trick!

papawjohn · Aug 12, 2005

Hey Y'all

One thing I learned when I worked in a PICU where the EXACT CONCENTRATION of IV drips was extra extra important--is that the manufacturers of IV bags routinely overfill them. I dunno why exactly. Assumed that it has to do with an assumption that the 1000 ml bag should have 1000 ml AFTER the tubing is primed.

There was a standard: remove 100 ml from the 1000 ml bag to get a REAL liter, 50 ml from a 500 ml bag etc.

It made me sensitive to drawing up the exact am't of medicine to put into those bags too. You've all had the experience (or will) of taking--say dopamine vials marked '400 mg/10ml' and drawing almost 11 ml up.

Happens all the time.

Anyhow--I don't think that programming the pump for 900 ml "to count" is so helpful--at least for me. I program in one liter, then do my darndest to have the NEXT bag hanging on the pole ready to spike at least an hour or two before the first bag is likely to run out. That way anybody can answer the alarm "infusion complete" if I'm busy next door.

Anyhow, that's what works for me.

PapawJohn

Daytonite, BSN, RN · Aug 18, 2005

They do this so the bag won't run dry which would result in them having to get air out of the IV line before hanging and infusing the next bag. It's a little difficult to get air out of the top part of IV tubing just below the drip chamber. The pump, will, in fact, let you know you have air in a line when air is noted by the air detector in the pump.

The other reason they do this is to warn them when a new bag is needed. They've got 100mL left in the current bag to infuse while they hunt up the next bag.

I don't know about Australia, but here in the U.S. the IV bags have an overfill of 50 to 75mL, so it really is unnecessary to dial in only 900mL on a pump when a new bag is hung.

AuntieRN · Aug 30, 2005

We were taught this in school as well so that you would know when the bag was almost empty and could change it before it totally ran out.