air contamination in saline bottle by nurse?
Answers
Primary and secondary IV tubing and add-on devices (extension tubing) must be primed with IV solution to remove air from the tubing. Priming refers to placing IV fluid in IV tubing to remove all air prior to attaching the IV tube to the patient. IV tubing is primed to prevent air from entering the circulatory system. An air embolism is a potential complication of IV therapy and can enter a patient’s blood system through cut tubing, unprimed IV tubing, access ports, and drip chambers with too little fluid (Perry et al., 2014). It is unknown how much air will cause death, but deaths have been reported with as little as 10 ml of air. The best way to avoid air bubbles in IV tubing is to prevent them in the first place (Perry et al., 2014). New IV tubing may also be required if leaking occurs around the tube connecting to the IV solution, if the tubing becomes damaged, or if it becomes contaminated. Checklist 66 outlines the process of priming IV tubing.
Steps
Additional Information
1. Perform hand hygiene. This step prevents the transmission of microorganisms.
2. Check order to verify solution, rate, and frequency. This ensures IV solution is correct and helps prevent medication error.
3. Gather supplies. You will need IV solution, primary IV tubing, time label, change label, alcohol swab, and basin or sink.
Sterile IV solution
Sterile IV solution
4. Remove IV solution from outer packaging and gently squeeze. Tear the perforated corner of the outer packaging; check colour, clarity, and expiration date.
Remove IV solution from packaging
Remove IV solution from packaging
5. Remove primary IV tubing from outer packaging.
IV tubing
IV tubing
6. Move the roller clamp about 3 cm below the drip chamber and close the clamp.
Moving roller clamp
Move roller clamp
7. Remove the protective cover on the IV solution port and keep sterile. Remove the protective cover on the IV tubing spike. Be careful and do not contaminate the spike.
Remove protective cover off spike on IV tubing
Remove protective cover from spike on IV tubing
8. Without contaminating the solution port, carefully insert the IV tubing spike into the port, gently pushing and twisting.
Spiking an Iv solution bag with IV tubing
Insert IV spike into sterile solution using sterile technique
9. Hang bag on IV pole. The IV bag should be approximately one metre above the IV insertion site.
10. Fill the drip chamber one-third to one-half full by gently squeezing the chamber. Remove protective cover on the end of the tubing and keep sterile. Filling the drip chamber prevents air from entering the IV tubing.
Fill drip chamber
Fill drip chamber
11. With distal end of tubing over a basin or sink, slowly open roller clamp to prime the IV tubing. Invert backcheck valve and ports as the fluid passes through the tubing. Tap gently to remove air and to fill with fluid. Inverting and tapping the access ports and backcheck valve helps displace and remove air when priming the IV tubing.
Invert IV tubing when priming with solution
Invert IV tubing when priming with solution
12. Once IV tubing is primed, check the entire length of tubing to ensure no air bubbles are present. This step confirms that air is out of the IV tubing.
13. Close roller clamp. Cover end with sterile dead-ender or sterile protective cover. Hang tubing on IV pole to prevent from touching the ground. Keep the distal end sterile prior to connecting IV to patient.
14. Label tubing and IV bag with date, time, and initials. Label IV solution bag as per agency policy. Do not write directly on the IV bag.
Labeled IV bag
Labelled IV bag
15. Perform hand hygiene. This reduces the transmission of microorganisms.
Hand hygiene with ABHR
Hand hygiene with ABHR