Setting up an administration set

Stewart1990

Stewart1990

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In my book and on the dvd-rom it 'shows' how to properly set up an admin. set. I was even shown by an EMT (I'm 4 days away from my state test) how to set one up, but for some reason any step after squeezing the drip chamber till its half full just doesn't stick to me at all. Any pointers?
 
Stewart1990 said:
In my book and on the dvd-rom it 'shows' how to properly set up an admin. set. I was even shown by an EMT (I'm 4 days away from my state test) how to set one up, but for some reason any step after squeezing the drip chamber till its half full just doesn't stick to me at all. Any pointers?
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Just remember after you squeeze the drip chamber, you have to flush the line of air. Not flushing the line of air before hooking it up will kind of kill your patient. It will cause an air embolism that can cause the heart to lose it's prime to pump. So just remember that you don't wanna kill your patient, so you need to flush the line after filling the drip chamber.
 
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Sasha said:
You have to squeeze the chamber befoe you can flush the line of air. I don't know how to tell you to remember it, but I don't understand how one can forget it and set up an admin set... You can't go to the next step without it.
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Lol. No, I know the drip chamber part. It's AFTER that that things get hairy. Maybe I'm just overanalyzing. I just want to know that I got this right, because it's not covered on our states and were just pushed onto the field afterwards. I'm technically only a first responder right now and I've already been asked to do it and was absolutely clueless. We weren't taught it in class. (But it IS in our protocols)
 
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so, you just have a problem remembering what you do after you squeeze the drip chamber? in my opinion it really dosnt matter what "steps" you take to get the IV set up, just get it done (might be my military mentality) this is how i do it. get the bag, get the tubing, inspect, puncture bag, squeeze chamber, open the flow, get all the air/bubbles out (most, cant get them all) that should be it for setting it up. pretty simple...
 
Stewart1990 said:
Lol. No, I know the drip chamber part. It's AFTER that that things get hairy. Maybe I'm just overanalyzing. I just want to know that I got this right, because it's not covered on our states and were just pushed onto the field afterwards. I'm technically only a first responder right now and I've already been asked to do it and was absolutely clueless. We weren't taught it in class. (But it IS in our protocols)
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Sorry I misread but edited my post appropriately.
 
As I said, overanalyzing definatly comes into play. For me it's the confusion of caps, because our tubes look like frickin octopuses (or whatever the plural of octopus is) and figuring out which caps come off and which stay on and which ones you take off then put back.... I'm sorry if this seems pretty frivolous, it's just a concern I have and I want to ensure when I'm out there I'm providing the best patient care possible.
 
no worries... i was the same way when i started doing the IVs... its like that with anything... wait till you actually start sticking PTs!!! eventually you will understand the system and you will know how to set up an IV in a matter of seconds. and when you are in the ambo, and still are unsure on how to do it, just ask the paramedic.... dont worry about all the ports on the IV tubing, they are pointless to you, all you need to know is the top of the tubing and the very end...
 
Stewart1990 said:
In my book and on the dvd-rom it 'shows' how to properly set up an admin. set. I was even shown by an EMT (I'm 4 days away from my state test) how to set one up, but for some reason any step after squeezing the drip chamber till its half full just doesn't stick to me at all. Any pointers?
Click to expand...

http://www.dsf.health.state.pa.us/health/lib/health/ems/bls_skill_sheets.pdf

http://www.nremt.org/nremt/about/exam_coord_man.asp

Are you asking for testing reasons or for just general knowledge? Because you're required to set up an IV set according to your state.

If you're just wondering in order to help your partner, then you flush all of the air out of the line after squeezing the chamber once you have "spiked" the bag. That's it.
 
After you flush the line of air/bubbles, remember to turn off the flow! In holding it for the medic who is sticking, hold on to the cap at the very end, and when s/he grabs it, twist and pull. That's it, not difficult
 
To limit amount of fluid lost clearing the line make sure and pinch the line just below the drip chamber, then hang bag, squeeze drip chamber to proper level. Now release pinched part of line while holding end of line. You will have very few if any air bubbles to chase out. In fact most times doing it this way as soon as fluid comes out end you can shut it it off.

Why do I bring this up? I have seen many people use 100-200 cc in order to get the air bubbles out.
 
Sasha said:
Not flushing the line of air before hooking it up will kind of kill your patient. It will cause an air embolism that can cause the heart to lose it's prime to pump.
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Just so people don't freak out about small bubbles, you need a decent amount of air to cause that to the heart, some studies say 3-8ml/kg. In a 150lb person, that's nearly 200ml, almost as much as an IV bag itself. But to cause trouble in the lungs is less.

Yet another source says 20ml is fatal, but that's still a sizeable amount, and I doubt you'd miss that going down a line. :)




But before someone jumps on me--- Yes, do what you can to get rid of bubbles.
 
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Linuss said:
But before someone jumps on me--- Yes, do what you can to get rid of bubbles.
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Do it the way I mentioned on previous post and you will not have bubble trouble.
 
Linuss said:
Just so people don't freak out about small bubbles, you need a decent amount of air to cause that to the heart, some studies say 3-8ml/kg. In a 150lb person, that's nearly 200ml, almost as much as an IV bag itself. But to cause trouble in the lungs is less.

Yet another source says 20ml is fatal, but that's still a sizeable amount, and I doubt you'd miss that going down a line. :)
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Yep yep. It would be VERY unlikely to cause an air embolism with the lining in the extension sets. However, that being said.. it's still important to flush the set.
 
I had an RN explain to me that too many ppl get freaked out about air in the line. She further explained that since an IV is venous, the small amount of air that would be in the line if you would forget to flush it is so small compared to the volume of blood and the air would be absorbed prior to making it to the heart.

Nonetheless, always flush the line but dont get freaked if there are a few small bubbles.
 
Here is a tip on all those "caps" Grab them all and invert them. Think of each of those injection ports as a place that air bubble hide. Gather them all and hold them in your hand upside down until your fluid runs past. Once the fluid passes an inverted cap, there is no need to worry about air under it. so you just let it fall out of your hands and repeat this until you get to the end of the tube and DONT let that one fall out of your hands. If you do this right, you won't have any bubbles in your line. (unless you forgot to squeeze the drip chamber!)
 
Venous Air Embolism
Full Article: http://emedicine.medscape.com/article/761367-overview
The key factors determining the degree of morbidity and mortality in venous air emboli are related to the volume of gas entrainment, the rate of accumulation, and the patient’s position at the time of the event.1,6,11

Generally, small amounts of air are broken up in the capillary bed and absorbed from the circulation without producing symptoms. Traditionally, it has been estimated that more than 5 mL/kg of air displaced into the intravenous space is required for significant injury (shock or cardiac arrest) to occur. However, complications have been reported with as little as 20 mL of air (the length of an unprimed IV infusion tubing) that was injected intravenously. The injection of 2 or 3 mL of air into the cerebral circulation can be fatal.Furthermore, as little as 0.5 mL of air in the left anterior descending coronary artery has been shown to cause ventricular fibrillation.13Basically, the closer the vein of entrainment is to the right heart, the smaller the lethal volume is.
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I'd also like to add, that just because you don't think there's enough air in the line to cause harm to a patient, doesn't give you an excuse to not properly set up your equipment and play russian roulette with a patient's wellbeing.
 
hahah.... so you guys wont really appreciate this story, but hey it fits the bill... and i dont care. sooo me and some of my marines go out in town, we all get very drunk, me the most and we have a pretty good time... well we get back to the barracks and i ask one of the marines to give me an IV... (i train them how to do IVs, so when i go down they can give one to me) so one of the marines say "ooo i will do it" they love doing IVs, and they are very good at them, they dont ever shake... so, i sort of watch him set the bag up, and i tell him to open the flow, on the line... well, long story short he didnt do it, or he forgot or something... so he sticks me and gets me the first try, and he connects the tubing and tapes everything down... after about a minute i start feeling really weird, and my heart was beating REALLY fast... haha but it went away quickly, and i was fine... hahah thats really the only thing i remember from that night. so, the thing to take away from this story is, that it probably wont kill the PT but it probably will make them feel weird, and give them slight tachycardia...
 
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