Overview
This lecture explains and demonstrates how to properly spike an IV bag and prime IV tubing, key skills for safe IV therapy in nursing.
Purpose of Spiking and Priming
- Spiking means using the tubing spike to penetrate the IV bag to allow fluid withdrawal.
- Priming the tubing means filling it with solution to remove air, preventing air embolism.
Preparation and Safety
- Always perform hand hygiene and use aseptic technique to avoid contamination and infection.
- Verify the correct IV solution and patient before starting.
- Gather correct IV tubing and labeling supplies as required by your facility.
- Label tubing with start date, start time (military time), discard date, and your initials.
Tubing Change Protocols
- Change continuous tubing every 72–96 hours (CDC and hospital protocols vary).
- For blood, TPN, or lipid infusions, change tubing every 24 hours.
IV Tubing Components
- Spike: part that penetrates the IV bag (do not touch to avoid contamination).
- Drip chamber: squeeze to allow fluid entry and observe drip rate.
- Access ports: for medication administration.
- Pump key section: inserts into IV pump to set infusion rate.
- Roller clamp: controls fluid flow (keep in "off" position until bag is spiked).
- Patient end: connects to patient's IV access (keep covered until ready to use).
Steps to Spike and Prime IV Bag
- Put on gloves to avoid contamination and protect from medication.
- Remove caps from IV bag spiking port and tubing spike without touching sterile areas.
- Insert spike into spiking port with a twisting motion (not the medication port).
- Hang bag on IV pole; squeeze drip chamber to fill to fill line.
- Open roller clamp to let fluid flow through tubing and flush out air (prime the line).
- Loosen patient-end cap to let air escape; prime until no air bubbles remain.
- Inspect tubing for large air bubbles, flick to remove if needed, and re-prime as necessary.
- Close roller clamp and keep patient-end covered if not immediately connecting to patient.
Key Terms & Definitions
- Spike — The pointed end of IV tubing used to puncture the IV bag's port.
- Prime — To fill IV tubing with fluid to remove air before patient connection.
- Drip chamber — Clear chamber to monitor drops and fill before priming.
- Roller clamp — Device to control or stop fluid flow in IV tubing.
Action Items / Next Steps
- Practice spiking and priming IV tubing until proficient.
- Always follow your facility's IV tubing labeling and changing protocols.