IV Bag Spiking and Tubing Priming Lecture Notes

Introduction

• Presenter: Sears, Registered Nurse (RN)
• Objective: Demonstrate how to spike an IV bag and prime the tubing
• Definitions:
  • Spiking: Using the spike from the tubing to penetrate the IV bag to withdraw the solution
  • Priming: Filling the IV line with fluid to remove any air and avoid air embolism in the patient's bloodstream

Importance

• Essential skill for nurses, frequently used in standard care
• Necessary for administering medications and solutions like normal saline or heparin intravenously

Initial Steps

1. Hand Hygiene: Perform aseptic technique to prevent contamination
2. Solution Confirmation
   • Verify with physician's order
   • Ensure it matches the correct patient
3. IV Tubing Selection
   • Familiarize with facility-specific tubing
   • Ensure tubing is correctly labeled

Tubing Labeling

• Labeling Importance
  • Prevents waste and ensures continuity in patient care
  • Key for tracking tubing expiration
• CDC Guidelines
  • Continuous tubing: Change every 96 hours (facility may vary, e.g., 72 hours)
  • Blood products/TPN/lipids: Change every 24 hours

Tubing Label Process

• Fill out start date and time in military format
  • Example: Start date (3-10-2017), Time (0845)
• Calculate discard date based on facility protocol
  • Example: Discard (3-13-2017)
• Initial the label

Tubing Preparation

1. Open and Unkink Tubing
   • Remove tape
   • Apply label below the drip chamber for visibility
2. Tubing Components
   • Spike: Insert into the IV bag (do not touch to avoid contamination)
   • Drip Chamber: Squeeze to fill and control flow
   • Access Ports: For medication administration
   • Roller Clamp: Controls flow; keep in off position initially
   • Connection Part: Connects to patient (avoid contaminating inside)

Spiking the Bag

• Wear gloves to avoid contamination
• Identify the correct port (spiking port, not medication port)
• Use non-dominant hand to hold the bag
• Remove stoppers and caps carefully
• Insert spike into the spiking port with a twisting motion

Priming the Tubing

• Hang the bag
• Squeeze drip chamber to fill to the line
• Open roller clamp to allow fluid to prime the tubing
• Observe for air bubbles, flick to dissipate if needed
• Adjust flow to manage speed

Final Steps

• Connect to IV pump
  • Controls infusion rate
• Connect tubing to patient
• Keep the connection covered until ready to use
• Ensure roller clamp is off when not in use

Conclusion

• Practice regularly to master the skill
• Ensure aseptic technique is followed meticulously
• Proper labeling and procedure adherence are crucial