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06.10 Spiking & Priming IV Bags

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Overview

  1. Purpose
    1. In order to administer IV fluids, tubing needs to be attached to the fluid bag.
    2. This process is called “spiking and priming”
    3. It should be done carefully to avoid piercing the bag or getting air bubbles in the tubing.

Nursing Points

General

  1. Supplies needed
    1. Bag of fluids
    2. Primary tubing
    3. IV Pole
    4. IV Pump

Nursing Concepts

  1. Steps and Nursing Considerations
    1. Verify provider order
    2. ALWAYS follow 5 rights BEFORE preparing medication
      1. Right Patient
      2. Right Drug
      3. Right Dose
      4. Right Route
      5. Right Time
    3. ALWAYS prepare medications at the patient’s bedside
    4. Gather supplies
    5. Perform hand hygiene
    6. Don clean gloves
    7. Let the patient know what fluids they will be receiving
    8. Remove IV fluid bag from package if applicable
    9. Open IV tubing package
    10. Clamp tubing with roller clamp
      1. If it has multiple clamps, make sure all are open except the roller
    11. Invert the IV fluid bag and remove stopper from port
    12. Remove the cover from the spike on the IV tubing
    13. Insert the spike into the port on the bag
      1. Push and twist
      2. Straight in to avoid puncturing bag
    14. Turn the bag right-side up and hang on an IV pole
    15. Squeeze the drop chamber so it’s ½ full
    16. Slowly unclamp the roller clamp until the fluid starts flowing
    17. Use the roller clamp to control the flow until the tubing is full of the IV fluid
      1. Remove ALL air bubbles
      2. Prime over a sink or trashcan
      3. Not too quickly or air bubbles will form in tubing
    18. Clamp tubing once fully primed
    19. Attach the tubing to the patient’s IV access
      1. Scrub the hub for 30 seconds with alcohol scrub
      2. Twist the leur-lock in place
    20. Insert the tubing into your IV pump and program appropriately according to your orders
    21. AFTER administration
      1. Document administration
      2. If using barcode medication administration
        1. Scan all meds before preparing
        2. Confirm administration AFTER giving to patient
    22. Discard all used supplies
    23. Remove gloves
    24. Perform hand hygiene

Patient Education

  1. Indication and possible side effect(s) of medication(s)
  2. Signs to report to nurse or provider

Reference Links

Study Tools

Video Transcript

In this video, we’re going to show you how to spike and prime IV bags and tubing. You will do this both for primary infusions AND secondary infusions or piggybacks.

First, of course, verify your order and use your 5 rights. Then remove the IV fluid bag from its package.
Then you’ll open the IV tubing package and clamp the tubing with roller clamp. Make sure that’s the only clamp that’s clamped.
Now, invert the IV fluid bag and remove the stopper from the port.
Then, remove the cover from the spike on the IV tubing and insert the spike into the port on the bag. You may have to push and twist to get it all the way in, just make sure you’re going straight so you don’t puncture the bag.
Now you can turn the bag right-side up and hang it on an IV pole.
You want to squeeze the drop chamber so it’s about ½ full.
Now you can slowly unclamp the roller clamp until the fluid starts flowing, and use the roller clamp to control the flow until the tubing is full of the IV fluid.
Usually we’ll do this over a sink or a trashcan. Just make sure you get all the bubbles out of it, then clamp the tubing.
Now you’re ready to attach the tubing to the patient’s IV access. Make sure you scrub the hub for 30 seconds with alcohol scrub and then twist the leur-lock in place
Then insert the tubing into your IV pump and program appropriately according to your orders. Make sure you unclamp the tubing before you hit start!

And, of course, follow your 6 rights and document the med administration.

That’s it, make sure you check out the video on hanging an IV piggyback to learn how to hang a secondary infusion. Now, go out and be your best selves today. And, as always, happy nursing!

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