hi everyone so what we're going to go through now is one of the most common tasks that you
might need to do which is putting fluids up and priming a line now just to get started
here's a very typical fluid bag so this is csl or harmon solution pretty much one of the most
common solutions we'll use in anesthesia just as a general rule for any kind of maintenance fluids or
fluid resuscitation so really common crystalloid the other one's normal saline importantly all
the information about this bag is on the bag so you can see all the different millimoles
grams of solution the ph as well as the volume on there coming down here there's two entry ports to
this bag so the first one to note is this one here you have to uncap before you use the plunger for
your fluid line this little one here that you can see is where you can inject any additives
any other medications you want to include you can inject through that port there and all you need
is a sharp needle a hypodermic needle attached to a syringe and you can syringe anything into there
this is a relatively straightforward fluid line now what you'll notice is that there
is a drip chamber here a port here that you can puncture into the bag and then there's a number
of other features so you've got a regulated device here to change the speed of flow
and then you've got a one-way valve across here and then a few points where you can do an infusion
or add medications to the patient's fluid so first thing i want you to do is close off the fluid so
this roller comes down and that shuts off any kind of flow the next thing i do is i take this cap off
and then i puncture the fluid bag you'll notice that i've got a bin next to me because you'll
almost always in the first attempt have you know water running through so you really want to make
sure there's somewhere you can put that as well once i've punctured the puncture the bag i then
squeeze that drip chamber and that primes it with a little bit of water so essentially i just use
maybe about half of that chamber full of water like like so now the next thing i do is
i uncap this by just literally unscrewing that and then i have that over the bin and
the method of priming the line is literally just letting gravity work its way to flush
water through the whole of the line and you can see that now there's no
air bubbles so i'm making sure i'm checking the line making sure there's no air bubbles
so that line is almost fully primed except this line has this strange little side port if you want
to prime that what i do is i clamp off this area i unscrew this just a little bit and that allows
me to prime this as well so as you can see that that's a little bit of a tricky situation where
i've capped off this part here by just folding it on itself i've done maybe half a turn of that cap
there and then i'm just going to prime that as well this has its own clamp which i can clamp
just for safety once i've done that i close this off and i can either connect that to the line or
i can recap this as necessary and that's how i prime a very simple fluid line now a fluid line
with this pump chamber or pump set is a little bit more complicated it has a lot of the same features
but there's other things that i need to add to this line as well
now first of all i might just get started by as you remember getting my bin ready and also
taking this roller down to essentially stop any flow that's going to occur i then undo that bit
and i'm now able to puncture the fluid bag like so and prime the drip chamber that's all
pretty similar to the last to the last one again i prime it till it's about halfway
now what you're what you'll notice with this fluid line the first one is this chamber this chamber
there's a very particular way that you need to fill fill this and i'll show you that in a second
but also that this one has just one port where i can access medications that is proximal so really
a lot of the time what we do is we put this extra attachment called a heidelberg so all i'll do i
won't open that now but essentially i just that's got i just uncapped this and just plug it on to
the end and that allows me to now have another couple of ports where i can give medications
and run infusions for the patient so that's a really really cool little device that i'll add
on if i need to so now in terms of priming i want to get myself ready i've got this over the bin so
i don't make or create a mess and now i can hold this roller device in the same hand over the bin
you know you really wish you had three hands in some of these situations
what i then do to prime this is i turn this and flip this upside down so the water will
fill from the bottom of the chamber if you want to do it this way you just never have it filling
the whole chamber which can be a bit frustrating so i then undo the roller and you'll notice that
now it's filling up slowly from the bottom i can speed things up by just pumping like that
now once the chamber fills up it's filled now i can now drop it and just let
gravity do its work and essentially make sure all the air is gone from the line
until it and at that point i reclamp it and that's done that's all prime