Forum topic

4 posts / 0 new
Last post
cubeca
Priming of PCA tubing

Can anyone comment on their policy with regards to PCA tubing priming.We currently have a wide variety of practice. Nurses have concerns with priming the PCA tubing with a narcotic and then running a typical post op IV rate of 125ml/hr..They are concerned about the bolus ( .5ml) the patient would receive. ( our concentration is 5mg/ml ( morphine)

Thanks in advance

tbaugher
It's been quite some time
It's been quite some time since I have set up a PCA but here it goes. We used a 'Y' connector tubing with a back-check valve that was inline. The lowest port, closest to the patient was where the PCA was connected to.  Prime with medication to fill the lowest tubing just to where the 'Y' connection joins. Do not over prime to the into the mainline portion of the tubing so to not waste medication. Mainline IV fluids are then attached to the portion of the tubing that has the back-check valve inline. prime the rest of the tubing with the mainline IV fluids. Even if you slightly 'over-prime' the tubing with the medication when you flush with the mainline fluids your initial input into the patient will be whatever the mainline fluid is. We then would connect to the patient after first confirming with a second nurse all parameters and proper set-up was correct and patient education was performed. We then would give and initial dose (either called a bolus dose or clinician dose), evaluate patients' pain then instruct the patient to press the medication delivery button if appropriate at this point. Hope this helps.
cubeca
Thanks for your input..I

Thanks for your input..I always seem to have so many questions about practice-but we are a small hospital without an IV team..and  I am trying to get everyone playing off of the same sheet of music -without compromising patient safety!

Thanks Again

 Carol Cubellis

Gwen Irwin
The process that tbaugher

The process that tbaugher described is what we use.

I am not sure that bolus occurs in the scenario that you suggested.  The PCA dose may be more diluted by the mainline fluid, but not a bolus actually occurring.

Does this make sense?

Gwen Irwin

Austin, Texas

Log in or register to post comments