hey everyone it's s register nurse rn.com and in this video I'm going to demonstrate for you how to spike an IV bag and prime the tubing so what does Spike and prime mean spiking the bag means that we are going to use the spike from the tubing to penetrate the bag so we can withdraw the solution so it can go into the patient's bloodstream and priming the IV tubing means that we're going to take this solution and put it through our line to remove any air because we don't want to inject air into a patient's bloodstream because it can cause an air embolism so as a nurse you are going to be doing this all the time this is standard care so if you are a student or a new nurse um I really recommend that you get familiar with this skill and practice as much as you can so the whole goal of IV therapy is to take this bag of solution may just be basic normal Sal or a medication like heprin and we want to get this into the patient's bloodstream so it'll use tubing and it'll go through that tubing your pump will regulate it and then it'll go into the patient's bloodstream so that is a route of how we give medications okay first what you want to do is you want to perform hand hygiene because this skill requires that you use aseptic technique and we want to be very careful not to contaminate our bag or our IV tubing because we could cause the patient an infection and next what you want to do is you want to confirm that you have the right solution so you'll look at your physic's order look at your bag make sure it matches up and make sure that you have the right Patient next you'll want to get some IV tubing and every facility has different types of tubing depending on their supplier so get familiar with what you have but how you spike a bag and prime the tubing they all tend to work the same and also make sure that your bag comes with a label so you can label the tubing it's usually found sometimes staple to the bag inside the bag or you may have to pick it up in an Alco where Supply puts it but you will want this because it's very important that you label your tubing whenever you initiate new tubing because it expires and here are some key points you want to remember um with continuous tubing sets that you're going to use if you're not using it to um administer blood blood products or fat emotions like tpn or lipids the CD recommends that you change the frequency of the tubing every 96 hours which is 4 days however hospitals have their own protocols based on the cdc's protocols it's usually anywhere from 72 hours to 96 hours most of the places I've worked it's 72 hours so every 3 days now say you were going to be starting blood or a blood product or tpn or lipids um the CDC recommends that you change the tubing every 24 hours and that tends to be standard care for hospitals so always keep that in mind and the very first thing what I like to do is so I don't forget to label my tubing because it's really important because if another nurse comes in behind you taking over patient care they need to know when that tubing expires do they need to change it or they just going to have to throw the whole thing away because they're unsure and that waste supplies so I like to label my um little label first and so I don't forget because if I get really busy may get lost in the patient's bed fall on the floor and then I'll completely forget okay first we're going to fill out the start date and this is when you initiated it so go ahead and fill that part out so we're going to put March 10th 2017 and HR means hour and that's the time that you started it and this needs to be written in military time so we're going to put 0845 for 8:45 in the morning and then the discard date is when um this is according to your hospital protocol whenever they say that you need to to change it out so we'll say it's 72 hours so we'll need to discard this on 313 2017 and the hour will match up whenever you start it so 0845 and then put your initials now what we want to do is we want to open our tubing so just tear it open and take our tubing out and you want to unkink the tubing and remove any tape that's keeping the tubing together and what I like to do is I like to go ahead and apply my label to the tubing so I don't forget and the best place to do this is right below this drip chamber so whenever it's hanging up there on the pole everyone can see it and it's easy to find you don't have to look down or around it's just completely right there so we have it labeled now let's look at the parts of the IV tubing at the top underneath this cap is where you have the spot this part will go inside the bag to penetrate it so we can withdraw the fluids and you don't want to touch when this caps off that Spike because you will contaminate the tubing and you'll need to start all over below that this area right here is the drip chamber we will squeeze that when we start to allow the fluid to drop in there so we can get it to go through the line um as we go down we have these little access ports that is used to administer medications any IV pushes and as we go down through our tubing this part right here for this particular tubing set is for an IV pump and this acts as a key when it goes into the pump and you can set your rates um this part right here get really familiar with that because you will be using that a lot it's the roller clamp you just roll this part of the clamp to turn it off and we're going to keep it in the off position right now so whenever you always start turn it off because when we penetrate this bag we don't want all these fluids rushing out on us we want to be able to control it so it's in the off position right now and then this part right here is the part that will screw onto the patient IV central line whatever they have and we'll remove that blue cap and um whenever we remove the cap we want to be really careful not to touch the inside of that part of the part of that because um we can contaminate it now what we're going to do is we're going to spike the bag and whenever I do this I like to wear gloves because I don't want to get contaminated with whatever type of medications in here especially if you're going to be giving nitroglycerin or something like that you don't want to get that on your hands and I want to decrease the chances of me contaminating it myself so um what we're going to do is we're going to put this Spike inside the spike por now you have two ports on your IV bag you have a medication administration Port which we will not be using you use this port to instill medications into the fluids a lot of times Pharmacy does that and um you have right the side of it the spiking P so what we're going to do is we're going to hold the ivy bag in our non-dominant hand then we're going to pull this stopper off and then we're going to remove the cap from the tubing and we're going to be careful not to contaminate these by touching them and then we're just going to penetrate the spike into the spiking port and you really got to twist to get it in there you just it's not very easy you just can't slide it in there you got to really twist it okay and then we're going to turn it back and see nothing's flowing out because we have our clamper stopped so that's good and then we're going to hang it on the pole now we're going to squeeze our drip chamber and we want the fluid from the bag to enter into this chamber and to feel where this line is so we're going to squeeze it you got to give it a couple squeezes sometimes and that's about as much as we want now you're going to open up the clamp by turning it to this position and what's going to happen is that all that fluid from the drip chamber is going to drain through your tubing and this is what's called priming the line because we want to remove any air from the line and you will start to see it come out this area and this blue cap on here you'll probably have to loosen it a little bit so the fluid can come out so let's unclamp a roller clamp and I like to control the flow a little bit so it's not all coming out really fast here in a second it'll be coming and it'll start to drip out as you can see and you can let this drip into the sink or wherever you have access to let it drip and you want to let all the air bubbles get out you don't want any large air bubbles in your lime and our tubing is nice and primed now okay so you always want to just double check your line make sure there's no massive air bubbles in there so um here I just wanted to demonstrate for you so you can see what I'm talking about here's the fluid right here but from here to here is air we do not want that so um you can flick it a little bit and you need to ref flush your line just to make sure there's none in there um so it won't go to the patient so after you have primed your tubing you're ready to connect your bag to the IV pump which will control the rate of how fast your bag will drip in and you will connect the tubing to your patient this little blue cap twists off and you'll just screw this part into your patient's axess whatever they have and say that you're not ready to connect this yet um just make sure that you keep this part covered just so it doesn't become contaminated and put your roller clamp in the off position so your solution isn't spilling out everywhere okay so that wraps up how to spike an IV bag and Prime IV tubing thank you so much for watching and don't forget to subscribe to our channel for more videos