This is how I setup my TPN session
Supplies needed for a night of TPN: Tubing, Alcohol wipes, 2 new syringes, Vitamin vials, TPN bag, Blue mat
Time to clean the vials and ports that will come in contact with my line.
*You MUST scrub for 15-30 seconds for every new connection*
I do this for both vials and the TPN bag port at the same time since I just find it easier once the syringe is drawn.
Quite exciting, I know.
Now to draw up the vitamins from the vials. You first pull the plunger back to the amount of liquid needed from the vials to fill the syringe with air. I need 5mL of vitamins from each vial, so I take 5mL of air.
I then insert the syringe needle and invert the vial and push the air into the vial. Since the vial is already full, it will displace the air I pushed in, with liquid vitamins into the syringe.
For the most part it will fill itself up to the 5mL line but sometimes you will need to pull back on the plunger to get the rest of your vitamins into the syringe. Keep in mind that the needle will also need to be pulled back as you replace air for liquid, otherwise you will get bubbles in your syringe and need to start over.
To do the next vial, it is the same routine. Pull in 5mL of air into the syringe again even with the extra 5mL of liquid. The plunger will just be at 10mL instead of 5mL.
Inject the vitamin mixture into the TPN bag carefully. If it isn’t straight, you can poke the needle through the side and straight into your finger or out of the bag, wasting the whole bag and hurting yourself in the process. Also, it is good to drawback some of the fluid from the neck of that port and flush it a few times to get all the vitamins out of the neck and into the bag. I do this until the liquid I draw is completely white.
Next is to pop off the top to the TPN bag. Keep in mind that it is sterile underneath so do it carefully, even though it is often quite difficult. Make sure your hands are clean.
The cap is removed from the end of the tubing and the bag is stabbed, also difficult. Again, keep your hands clean. This is all supposed to remain sterile as any bugs here go straight to your heart. Make sure the end gets all the way through; you’ll know when TPN starts to move through the tubing.
I cheat on priming and perhaps am not the best to teach this part, but I’ve learned after a few months doing this as this is how all my nurses did it when I was in the hospital all those times. If you take the bag and hook it on something high and leave the end low, the TPN mixture just runs right through. Easiest way to prime. I no longer use the pump as this takes like a minute. Just make sure to use the clamp once it reaches the end!
Sorry, my Ellie is always there, helping whenever possible – had to include her.
Programming the pump and hooking in the cassette.
Always accessed so it is always dressed. I get to deaccess it myself on Monday and I’ll see about getting a picture of it then before they reaccess it. It isn’t so cute because of all the rashes and scars from those rashes but the actual incision looks beautiful.
More scrub a dub dubbing, preparing to flush with saline before I can hook up to my TPN bag.
Short pumps of saline at a time help clean everything out; just one syringe is necessary.
TaDa! All hooked up. Whew!
In the morning, when it runs out, clamp everything and grab 2 saline syringes and a heparin syringe for flushing the TPN out. The heparin stops it from clotting off and goes in last. Then I’m free to go back to bed or do whatever. Not really a bad situation.