Welcome to NurseMinder. My name is Tammy and today we are talking about IV
lines, and in particular what to do to prevent bubbles from getting into them
and to how to troubleshoot them when they do it appear - and we're going to talk
about that right after thi. Welcome back my name is Tammy and this is
NurseMinder and on this channel we do everything nursing so if you're new here
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Welcome back. We're talking today about the IV lin, priming it so that you don't
get air bubbles in it and two, troubleshooting when they do appear;
because they always seem to appear don't they? Yeah. So let's first look at our
tips to prevent air bubbles in our IV line. The supplies you will need are your
IV infusion fluid, in this case I'm going to use normal saline, and your IV line,
and in this case I'm using the Alaris pump infusion set.
Alright. Confession time. I don't have an IV pole so we're gonna use that nail in
the wall as my holder for my IV solution. You got to do what you got to do - right?
Okay so I've already checked my IV fluids I know that the expiry date is
good it's the right fluid for my patient and I'm going to take my IV line and get
that ready. One of the very first things you want to do is lock this roller clamp.
So we're going to take this all the way down, and that is the first step we're
going to do. I'm also going to remove all these pieces of paper they don't need to
stay on here, you're welcome to keep them on that's not a problem - and stretch out
my line.Okay now the second thing I'm going to do is -
I'm gonna hold up my IV line. I'm actually going to create a second clamp and
I'm just going to hold it like this.
We're gonna remove the blue sheath from my fluid. We don't want that to touch
anything, and I'm gonna remove the protective sheath on my IV - I an going to switch sides here.
Now we're going to spike the bag. Okay so that's it in, I'm still holding this tight.
Let's zoom in a bit for you. Give it a squeeze and fill in that fluid here.
Now I'm gonna stretch this out and I can see I do have a bubble in there but
that's okay it's gonna come up. Now we're going to open up my clamp. Now if you have
the Y port you can hold those Y ports upside down and what that will do
is as the fluid is priming through it will fill the base of this first and
then it will carry on. So let's open up my clamp and you can see the water is
now flowing through, and it's got that one little bubble - it's chased out.
Final inspection and this line is bubble- free. So next we're going to talk about
troubleshooting when there are air bubbles, so I've put an air bubble in
here so that we can actually go through this and it's quite a large one - I'll
bring it closer for you to see. You can see that there's this air bubble
right here, and that's quite a significant air bubble so we definitely
want to get that out. So this air bubble in particular, happens to be above
the first lure lock. All we are going to do is grab a sterile syringe, cleanse the hub, and then
we're gonna withdraw fluid so that the bubble comes out. Alright so we're gonna
do our cleaning. You always want to do a 15 second scrub to make sure that we are reducing
the risk of any microbes being introduced when we do attach our sterile
syringe. Even though it is sterile we still want to clean the hub. Now we're
going to just screw this on, and here's the other important piece. You need to
actually clamp below the line so let me anatomically move this. We're going to clamp
below so that the fluids that this syringe is gonna pull is actually coming
from above and it's gonna grab that air bubble. Alright so let's see if you can
see the air bubble as it comes.
There so I've removed all of the ai, you can see it inside the syringe here.
Detach. And my line is now clean. Now with the Alaris line in particular
sometimes the air bubbles get in this sheath so we're gonna remove this sheath
now and this is the part that sits in the Alaris pump and this is the part
that will beep when there are air bubbles. And so you can stretch this - it
is stretchy - and then just flick it because air will rise so depending on
which direction you want those air bubbles to go, you're just gonna flick
that and then hopefully those air bubbles will clear out of that line. Okay
so now what happens when the air bubbles are below this sheath and so I've got
one, where is it now, here they are - you can see those traveling along
beautifully but we don't want those in there. So I'm going to clamp and now
these air bubbles are just above the port that's going to my patient. So I
would do the same process here I would clean the hub, clamp below, imagine this
is attached to my patient, clamp below, attach your 10 cc syringe and allow for
those bubbles to come out. So we're gonna clean, always 15 seconds. There's no
cheating in this because this is- you know - an extremely important process to
make sure our patients are safe. I know 15 seconds feels like a really
long time but it's not that bad. We're gonna attach your sterile syringe, clamp
below, so I've got this pinched off so I'm not pulling blood back from my
patient, and where is that? Here it is. We're gonna watch those- get those air
bubbles next. Oh. gotta make sure it unclamp, that's a pretty common thing.
Ain't nothin moving if I'm not on clamped. There we go,
and you can just scooch those out before they even get to the patient. And there's
one more coming, there we go. Now here's a question. What if this is medication?
We definitely want to make sure the patient gets that medication, so I'm
going to detach here. This fluid can continue now to go into my patient
and then I could reinsert the medication into this bag. You would clean this port,
you would attach your blunt end needle, clean this port and you could infuse the
medication back into the bag so the patient is receiving all of it. All right.
So as a quick review, before you prime your bag, you're going to close the clamp.
that's your first clamp. And then you're going to make your second clamp by
holding the line tight up against your chamber. So there we go, close our first
clamp and we're going to make a second clamp -that's going to help ensure that
we don't get bubbles. If we need to troubleshoot that bubble, we're going to
grab a sterile syringe and attach it to the port that's closest to the air
bubble where the air bubble has not passed yet. Now we're going to create a
clamp below that port, attach our sterile syringe and withdraw the air. Now if it
happens to be past the very last port and it's headed towards your patient. You
can disconnect from the patient, let it run, so we're going to lose just this
little few cc's here to get that air bubble out and then reattach it to your
patient. Thanks for watching. Now if you like this video, give it a like, hit the
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have any comments please share them. This video was actually created because
someone had asked me "what do I do when ..." So I do listen to your comments and I do
respond. Thanks again for watching and you know what's coming next! Make it a
great day!! :)