Removing air from epidural bag preparations?

[powertoold]

Hey everyone,

Do you guys remove the residual air from your epidural bag preparations in the sterile prep. room? Some people at work tell me that it needs to be done to prevent air from getting into the epidural space after the bag has finished infusing, but I can't find any information on it. Is it a necessity or a remnant of the past, where epidural pumps weren't able to detect air bubbles in the line?

Not all the pharmacists know about it, and we've sent thousands of epidural bags with 5-8 mL of air in them with no problems.

Thanks for your input!

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[njac]

I think it depends on the type of bags and pumps you use.

I worked at one hospital that used specific small bags that were a different plastic - and we did take the air out of those. Current place makes epidurals in regular IV bags and does not.

 

[xiphoid2010]

Hey everyone,

Do you guys remove the residual air from your epidural bag preparations in the sterile prep. room? Some people at work tell me that it needs to be done to prevent air from getting into the epidural space after the bag has finished infusing, but I can't find any information on it. Is it a necessity or a remnant of the past, where epidural pumps weren't able to detect air bubbles in the line?

Not all the pharmacists know about it, and we've sent thousands of epidural bags with 5-8 mL of air in them with no problems.

Thanks for your input!

I did, but that's more due to how I was trained as an intern than anything evidence based. But why not? Just taking a tiny bit longer to make, better safe than sorry I say.

 

[confettiflyer]

I think I may file this under the "pharmaceutical elegance" file heading.

 

[sakigt]

We pull the air out of ours as well.

The premade ones, now that I think about it, don't have excess air in them either....

 

[Praziquantel86]

I trained to remove the air, as well. I'm not sure if it matters with the modern pumps, but better to err on the side of safety I suppose. Pharmaceutical elegance too!

 

[68quebec]

I always pull air our for epidurals in sterile hood.

 

[spacecowgirl]

We never take the air out. Never crossed my mind. Our pumps detect air and shut off. Interesting though...

 

[powertoold]

Thanks for all your input! I'm thinking this is under "elegance" too. I really tried to find "safety" reasons, but I haven't been able to find them (in manuals / Google anyway).

 

[rxlea]

We always took air out.

 

[patmcd]

Sounds like it might be a hangover from the days before today's fancy smart pumps.

 

[xiphoid2010]

Sounds like it might be a hangover from the days before today's fancy smart pumps.

but pumps, like all things, also malfunction or fail. The chances might be tiny, but drawing the air out with the last injection takes what, extra 5-10 seconds?

 

[powertoold]

but pumps, like all things, also malfunction or fail. The chances might be tiny, but drawing the air out with the last injection takes what, extra 5-10 seconds?

I think it's a lot more likely that air is infused with a un-primed line than it is with an empty bag. Plus, many things have to go wrong in order to infuse the air in the bag. First, the pump has to be programmed with a larger volume than supplied, which should be fairly rare. Then, the pump has to have an unknown air detector malfunction, which is very rare.

It's a risk vs benefit problem, and I don't know if that extra 5-10 seconds per bag is worth it? Although it does make the bag look more appealing 😀

 

[rxlea]

but pumps, like all things, also malfunction or fail. The chances might be tiny, but drawing the air out with the last injection takes what, extra 5-10 seconds?

This

 

[BidingMyTime]

I've never heard of doing this before. It makes sense from a safety standpoint, however remote the risk may be. But like Spacecowgirl, I've never seen anyone do this before, and it had never crossed my mind to do it.