Changing Intravenous Tubing and Fluids

Perform hand hygiene and ensure privacy

Introduce yourself to the patient and identify her using to identify errs hi

My name is Kayla I'm gonna be the nurse that's taking care of you

How are you

Doing okay

alrighty it's time to change out your IV fluid and your tubing so I'm going to get started
with that I'm gonna go ahead and scan your armband and can you verify your name for
me Sally lakeshore ok and your date of birth 1 2 55

it's best to coordinate IV tubing changes with solution changes when possible prepare
your patient for a solution and tubing

Changed by explaining the purpose of the procedure and discussing what's expected of
her prepare the solution at least one hour in advance or if the pharmacy

Prepares the solution make sure it's been delivered to the patient care unit if the
solution has been refrigerated

allow it to reach room temperature examine the label to make sure you have the correct
solution and that it's properly labeled including an expiration date be sure to follow the
necessary

Restrictions if the solution is light-sensitive open the new infusion set and connect any
add-on pieces such as filters and extension tubing keep the protective covers on the
infusion spike and distal adaptor secure all connections

I'm gonna take a look at your IV check the IV site for redness swelling or discomfort is it
bothering you at all no put on clean gloves and make sure the patient's IV cannula hub is
visible if it's not remove

The IV dressing don't remove the tape that secures the cannula to the skin hang the
solution bag on the IV pole if you're preparing new tubing for an existing continuous
infusion move the roller clamp on the new tubing to the off position use the electronic
infusion device known as an eID or roller clamp to slow the rate at which the fluid is
infusing through the old tubing set it to the keep vein open

rate place the insertion spike of a new tubing into the solution container compress and
release the drip chamber on the new tubing filling it one third to one half full tap the IV
tubing to remove air bubbles slowly

Open the roller clamp removing the protective cap from the distal end if necessary
Prime the new tubing with solution then stop the infusion by closing the clamp and
putting the protective cap back on the distal end of the tubing place the end of the
adapter near the patient's IV

Site if you're using an electronic infusion device or eid pause it turn the roller clamp on
the old tubing to the off position and remove it from the IV access device then insert the
new tubing into the IV access device.

If you need to prepare tubing with an extension set or saline lock use sterile technique
to connect the new injection cap to the new extension set or tubing if necessary insert a
syringe containing three to five milliliters of saline inject the solution through the cap
into the extension set.

Now re-establish the infusion gently disconnect the old tubing from the extension
tubing or from the IV catheter hub apply gentle pressure above the IV catheter hub to
prevent leakage of blood from the catheter quickly insert the adapter of the new tubing
or saline lock into the extension tubing connection or IV catheter hub for a continuous
infusion

Use the roller clamp or eid to regulate the drip rate a sex tape or a label pre-printed with
a date and time of the tubing change to the tubing below the drip chamber loop

The tubing and secure it to the patient's arm with tape how does everything feel it's fine
be sure to remove and discard the old IV tubing if necessary apply a new dressing at the
IV site finally remove and dispose of your used gloves and perform hand hygiene

Hi my name is Kol be the nurse that's taking care of you how are you doing

Good
all right it's time for us to change out your IV fluid so I'm going to get started on that log
into the computer identify the patient and explain what you're going to do.

We need to scan your armband and can you verify your first and last name for me

Mahesh Chiba

All right and your date of

Birth

January 13 1962

To change the IV solution without changing the tubing

Begin by collecting the necessary equipment check the solution as shown earlier in this
video

You’ll change the solution when the level drops to about 50 milliliters in the neck of the
container

Perform hand hygiene

Close the roller clamp on the existing tubing to stop the flow of solution to prepare the
new solution

Hang the IV bag on the pole

If you're changing a glass bottle remove the metal cap as well as the metal and rubber
disks

Take the old container down off the IV pole holding it with the tubing port facing up
quickly remove the spike from the old container

Remove the protective cover from the new IV bag and without touching the spike tip
insert the spike into the new container
Check the tubing for air bubbles if any bubbles have formed remove them by closing the
roller clamp stretching the tubing downward and tapping it the bubbles in the fluid will
rise into the drip chamber how's your IV feeling right

Now okay look out some of these air bubbles make sure the drip chamber is 1/3 to 1/2
full if it's more than half full pinch off the tubing below the chamber and invert the IV
container

Squeeze and release the chamber turn the container upright and let go of the tubing
regulate the flow rate with the roller clamp or eid

Okay okay yeah it still looks great

Can I get you anything right now?

I'm good

Okay if you change your mind this red button right here is the car light you can just press
that somebody will be in to help you out shortly

okay okay

alrighty I'll be back to check on you in just a few minutes

Okay document the addition of new fluids or change in existing fluids in the medication
administration

Record ma R or IV fluid flow sheet as directed by agency policy frequency of tubing

Changes depends on the type of fluids administered additives and use of blood
products follow agency policy and requirements to determine frequency of tubing
changes

https://www.youtube.com/watch?v=XTwoAmjJSY4