Setting up an administration set

that it probably wont kill the PT but it probably will make them feel weird, and give them slight tachycardia...
Click to expand...

Maybe it wont kill a healthy patient, but why take the risk? Do your job and flush a bad, it's not a difficult process. Just because it didn't kill you doesn't mean it can't kill someone else.
 
Who is saying not to flush the line? Who said flushing the line doesnt matter? A point was made not to get all bent out of shape over a few bubble in the line. That is it...
 
yeah, you probably dont wanna give the 176 year old grandma the line of air... she probly wont make it... then again she probly wont mind. haha... but yeah, in all reality of course make sure you flush the line, but dont make it distract you, and mess up something much more important. if the line has a bunch of little bubbles dont worry about it...
 
I've heard no mention of aseptic technique. whether you're spiking the bag, or handing the medic the distal end of the tubing, neither end should be contaminated at any time. Anything the tubing touches will be going into the pt. Have some alcohol preps available for the medic as well, should they need to hit a port for med admin.

For EMT's that are confused as to what goes where, a fluid bag will have two protrusions. One is to add medication to the bag, and the other is for you to "spike" with the administration set. It will be obvious where it goes if you just look at it. Also make sure that it's a macro drip set. You shouldn't be spiking a bag with a 60gtt set as the medic will need to add medication and then run it through the tubing themselves.
 
yeah, forgot about the whole macro/micro... you will see a difference between the two by looking at the drip chamber, if there is a thin needle inside the drip chamber then it is micro.

try not to get caught around the whole aseptic thing either... just know not to dip the end, in blood, or dirt, or anything nasty.
 
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.
Click to expand...

As Linuss pointed out, that takes a tremendous amount of air. The bigger risk with air embolism is the risk of vascular obstruction when the patient has a structural cardiac defect and the air crosses into the left side of the heart and into system circulation.

Normally small bubbles in the form of a venous gas embolism (VGE) are filtered out by the lungs and only when you have a structural issue in the heart- such as patent foramen ovale (PFO), ostium secundum atrial septal defect or ventricular septal defect (three different forms of a "hole in the heart" to use common terminology) is there an increased risk to air embolism. We do "bubble studies" from time to time (I've done one in the past six years) in echocardiography and that involves intentional administration of air into the venous system as a way to diagnose cardiac structural defects. Keep in mind that patent foramen ovale occurs in about one out of five or ten people (depending on which study and which population you're dealing with).

The greater risk with air embolism is with arterial lines since an arterial gas embolism (AGE) is the ones that are more likely to wind up lodged in bad places (coronary arteries, the arteries supplying the brain, the mesentery). VGEs generally only become a problem if they get "converted into AGEs" by way of a septal defect or (less commonly) a pulmonary arteriovenous malformation.

That said, always be sure to flush the line of as much air as possible when setting up IVs.
 
To go along with others have said I was taught to run the roller clamp all the way up the line to the drip chamber. Close it off at the drip chamber, fill the chamber then open the roller clamp, by the time you get fluid at the end of the line you shouldn't have any bubbles or only a couple. Works VERY VERY well and you always know where your roller clamp is.
 
On the topic of Aseptic technique... one thing that I hate to see is a Medic or EMT drop the end of the line or the primed saline loc on the floor of the ambulance or ne where for that matter and than proceed to still use it.

Very poor practice and have seen it a lot.
 
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...

Could you list the steps for us after squeezing the drip chamber?

It's a bit hard to advise you, because there aren't many steps after that point, so not sure which you're forgetting.
 
ResTech said:
On the topic of Aseptic technique... one thing that I hate to see is a Medic or EMT drop the end of the line or the primed saline loc on the floor of the ambulance or ne where for that matter and than proceed to still use it.

Very poor practice and have seen it a lot.
Click to expand...
Poor practice for sure. Though, I have always wondered what the actual complications rate has been due to that happening.
 
I'd venture that it'd be way too hard and time consuming to follow.
 
You must log in or register to reply here.
Back
Top