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Protocols

Review maintenance and usage protocols for the following:
Continuous Infusion on Curlin Pump

Gather Supplies:

  • (1) Bag of _______ (medication)
  • (1) Pre-filled syringe of Saline
  • Alcohol Prep Pads
  • Curlin tubing

Procedure:

  1. Wash hands thoroughly with liquid soap for at least 20 seconds and dry with paper towels
  2. Open curlin tubing package (IV tubing good for 3 days)
  3. Break off tab on yellow piece of tubing.
  4. Remove tab from IV bag
  5. Remove cap from spike on tubing (be sure not to bump this against anything)
  6. Insert spike into IV bag by pushing and twisting until you reach lip on spike
  7. Remove air from tubing by holding bag up and squeezing yellow piece on tubing until fluid reaches bottom of tubing.
  8. Load tubing into pump by opening door on top of pump. Place pump on its side with the keypad facing towards you. Load blue piece on tubing into hole by the blue arrow in pump, then set pump upright and load yellow piece on tubing into hole by the yellow
    arrow in pump. Close door.
  9. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  10. Clean end of PICC line with alcohol swab for 10- 15 seconds
  11. Attach saline flush to PICC line
  12. Open clamp on PICC line
  13. Flush PICC line with saline flush
  14. Remove empty flush from PICC line and discard
  15. Clean end of PICC line with new alcohol swab for 10-15 seconds
  16. Remove cap from end of IV tubing and attach tubing to PICC line
  17. Turn Pump On. Pump will go through self-test. Then show how full batteries are.
  18. When pump reads “Program: – hit the YES button on the pump
  19. When pump reads “Repeat Rx” – hit the YES button on the pump
  20. Once pump reads through settings, hit the RUN button on the pump to start infusion
  21. When infusion is complete – Pump will beep and read “Infusion Complete.”
  22. Wash hands thoroughly with liquid soap for at least 20 seconds and dry with paper towels.
  23. Change batteries. Batteries are changed in the back of pump. Slide door to unlock and then slide down. Pull batteries out and replace with (2) C batteries that face the same way.
  24. Take tab off of new IV bag, remove spike of tubing from empty IV bag and immediately insert into new IV bag.
  25. Turn pump on and follow steps 18-20.
Continuous TPN on Curlin Pump (Not Pre-Spiked)

Gather Supplies:

  • (1) Bag of TPN
  • (1) Pre-filled syringe of Saline
  • Alcohol Prep Pads
  • Curlin tubing

NOTE: If you have additives, refer to your nurse before starting.

Procedure:

  1. Wash hands thoroughly with liquid soap for at least 20 seconds and dry with paper towels
  2. Open curlin tubing package 
  3. Break off tab on yellow piece of tubing.
  4. Remove tab from IV bag
  5. Remove cap from spike on tubing (be sure not to bump this against anything)
  6. Insert spike into IV bag by pushing and twisting until you reach lip on spike
  7. Remove air from tubing by holding bag up and squeezing yellow piece on tubing until fluid reaches bottom of tubing.
  8. Load tubing into pump by opening door on top of pump, where it says “Lift to Open”. Place pump on its side with the keypad facing towards you. Load blue piece on tubing into hole by the blue arrow in pump, then set pump upright and load yellow piece on tubing into hole by the yellow arrow in pump. Close door. Door must be flush with top of pump.
  9. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  10. Clean end of PICC line with alcohol swab for 10 – 15 seconds
  11. Attach saline flush to PICC line
  12. Open clamp on PICC line
  13. Flush PICC line with saline flush
  14. Remove empty flush from PICC line and discard
  15. Clean end of PICC line with new alcohol swab for 10-15 seconds
  16. Remove cap from end of IV tubing and attach tubing to PICC line
  17. Turn Pump On. Pump will go through self-test. Then show how full batteries are.
  18. When pump reads “Program: – ensure “Program” is highlighted, then hit the YES button on the pump
  19. When pump reads “Repeat Rx” – hit the YES button on the pump
  20. Once pump reads through settings, hit the RUN button on the pump to start infusion
  21. When infusion is complete – Pump will beep and read “Infusion Complete.”
  22. Wash hands thoroughly with liquid soap for at least 20 seconds and dry with paper towels.
  23. Change batteries. Batteries are changed in the back of pump. Slide door to unlock and then slide down. Pull batteries out and replace with (2) C batteries that face the same way.
  24. Start at beginning.

 

Continuous Readymed

Gather Supplies:

  • (1) Medication ball of ________ (removed from refrigerator 12 hours before use)
  • (1) Pre-filled syringes of Saline
  • Alcohol Prep Pads

Procedure:

  1. Wash hands thoroughly with liquid soap for at least 20 seconds and dry with paper towels
  2. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  3. Clean end of PICC line with alcohol swab for 10-15 seconds
  4. Attach saline flush to PICC line
  5. Open clamp on PICC line
  6. Flush PICC line with saline flush
  7. Remove empty flush from PICC line and discard
  8. Clean end of PICC line with new alcohol swab for 10-15 seconds
  9. Remove cap from end of medication ball and attach tubing to PICC line
  10. Open clamp on medication ball. (Check medication ball in a couple of hours – you should notice that medication ball is visibly getting smaller with some wrinkles and
    dimples in it)
  11. When infusion is complete in 24 hours (medication ball should be flat)– Wash hands thoroughly with liquid soap for at least 20 seconds and dry with paper towels.
  12. Disconnect medication ball tubing from the end of PICC line and discard
  13. Repeat, starting at step 2.
Cyclic TPN

Cyclic TPN:

            Gather Supplies:

  • (1) Bag of TPN
  • (2) Pre-filled syringes of Saline
  • (1) Pre-filled syringe of Heparin
  • Alcohol Prep Pads
  • Curlin tubing

Procedure:

  1. Wash hands thoroughly with liquid soap for at least 20 seconds and dry with paper towels
  2. Open curlin tubing package
  3. Break off tab on yellow piece of tubing.
  4. Remove tab from TPN bag
  5. Remove cap from spike on tubing (be sure not to bump this against anything)
  6. Insert spike into TPN bag by pushing and twisting until you reach lip on spike
  7. Remove air from tubing by holding bag up and squeezing yellow piece on tubing until fluid reaches bottom of tubing.
  8. Load tubing into pump by opening door on top of pump. Place pump on its side with the keypad facing towards you. Load blue piece on tubing into hole by the blue arrow in pump, then set pump upright and load yellow piece on tubing into hole by the yellow arrow in pump. Close door.
  9. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  10. Clean end of PICC line with alcohol swab for 10- 15 seconds
  11. Attach saline flush to PICC line
  12. Open clamp on PICC line
  13. Flush PICC line with saline flush
  14. Remove empty flush from PICC line and discard
  15. Clean end of PICC line with new alcohol swab for 10-15 seconds
  16. Remove cap from end of IV tubing and attach tubing to PICC line
  17. Turn Pump On. Pump will go through self-test. Then show how full batteries are.
    1. Make sure you change your batteries daily, you should always start with fresh batteries.
  18. When pump reads “Program: – hit the YES button on the pump
  19. When pump reads “Repeat Rx” – hit the YES button on the pump
  20. Once pump reads through settings, hit the RUN button on the pump to start infusion
  21. When infusion is complete – Pump will beep and read “Infusion Complete.” Turn pump OFF
  22. Wash hands thoroughly with liquid soap for at least 20 seconds and dry with paper towels.
  23. Disconnect tubing from the end of PICC line and discard
  24. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  25. Clean end of PICC line with new alcohol swab for 10-15 seconds
  26. Attach saline flush to PICC line and flush PICC line with saline
  27. Remove empty flush from PICC line and discard
  28. Prepare heparin flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  29. Clean end of PICC line with new alcohol swab for 10-15 seconds
  30. Attach heparin flush to PICC line and flush PICC line with heparin
  31. Close clamp on PICC line
  32. Remove empty heparin flush and discard

 

NOTE: If you have additives, refer to your nurse before starting

Dial–A-Flow

Gather Supplies:

  • (1) Bag of __________ (medication)
  • (2) Pre-filled syringes of Saline
  • (1) Pre-filled syringe of Heparin
  • Alcohol Prep Pads
  • Dial-A-Flow tubing
  • (1) Blue sterile cover

Procedure:

  1. Wash hands thoroughly with liquid soap for at least 20 seconds and dry with paper towels
  2. Open dial-a-flow tubing package (IV tubing is good to use for 3 days)
  3. Pinch white clamp on tubing
  4. Remove tab from IV bag
  5. Remove cap from spike on tubing (be sure not to bump this against anything)
  6. Insert spike into IV bag by pushing and twisting until you reach lip on spike
  7. Hang bag, ensure this is above heart level (the higher the better)
  8. Squeeze and fill drip chamber ½ way
  9. Remove air from tubing by opening white pinch clamp on tubing until fluid reaches bottom of tubing
  10. Pinch white clamp back off. Set IV tubing aside.
  11. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  12. Clean end of PICC line with alcohol swab for 10- 15 seconds
  13. Attach saline flush to PICC line
  14. Open clamp on PICC line
  15. Flush PICC line with saline flush
  16. Remove empty flush from PICC line and discard
  17. Clean end of PICC line with new alcohol swab for 10-15 seconds
  18. Remove cap from end of IV tubing and attach tubing to PICC line
  19. Turn dial to rate of _______ ml/hr
  20. Open white clamp and check chamber at top of tubing for drips
  21. When infusion is complete – Pinch white clamp on tubing off
  22. Disconnect tubing from the end of PICC line and immediately cap with new blue sterile cover.
  23. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  24. Clean end of PICC line with new alcohol swab for 10-15 seconds
  25. Attach saline flush to PICC line and flush PICC line with saline
  26. Remove empty flush from PICC line and discard
  27. Prepare heparin flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  28. Clean end of PICC line with new alcohol swab for 10-15 seconds
  29. Attach heparin flush to PICC line and flush PICC line with heparin
  30. Close clamp on PICC line
  31. Remove empty heparin flush and discard

 

NOTE: Leave empty medication bag on the IV tubing until the next dose, then change to a new bag when dose is due.

Gravity

Gather Supplies:

  • (1) Bag of __________ (medication)
  • (2) Pre-filled syringes of Saline
  • (1) Pre-filled syringe of Heparin
  • Alcohol Prep Pads
  • Gravity tubing
  • (1) Blue sterile cover

Procedure:

  1. Wash hands thoroughly with liquid soap for at least 20 seconds and dry with paper towels
  2. Open gravity tubing package (IV tubing is good to use for 3 days)
  3. Pull roller-clamp towards bottom of tubing, and close the roller-clamp by rolling it all the way to bottom.
  4. Remove tab from IV bag
  5. Remove cap from spike on tubing (be sure not to bump this against anything)
  6. Insert spike into IV bag by pushing and twisting until you reach lip on spike
  7. Hang bag
  8. Squeeze and fill drip chamber ½ way
  9. Remove air from tubing by rolling roller-clamp up on tubing until fluid reaches bottom of tubing
  10. Close roller-clamp on tubing by rolling down to bottom. Set aside.
  11. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  12. Clean end of PICC line with alcohol swab for 10-15 seconds
  13. Attach saline flush to PICC line
  14. Open clamp on PICC line
  15. Flush PICC line with saline flush
  16. Remove empty flush from PICC line and discard
  17. Clean end of PICC line with new alcohol swab for 10-15 seconds
  18. Remove cap from end of IV tubing and attach tubing to PICC line
  19. Open roller-clamp slowly until the desired number of drops as directed is achieved. Refer to IV label for drip rate. (If infusion is going too quickly – roll clamp down a little, if infusion is going too slowly – roll clamp up a little)
  20. When infusion is complete – Roll roller-clamp to bottom to pinch off tubing.
  21. Disconnect tubing from the end of PICC line and immediately cap with new blue sterile cover.
  22. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  23. Clean end of PICC line with new alcohol swab for 10-15 seconds
  24. Attach saline flush to PICC line and flush PICC line with saline
  25. Remove empty flush from PICC line and discard
  26. Prepare heparin flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  27. Clean end of PICC line with new alcohol swab for 10-15 seconds
  28. Attach heparin flush to PICC line and flush PICC line with heparin
  29. Close clamp on PICC line
  30. Remove empty heparin flush and discard

 

NOTE: Leave empty medication bag on the IV tubing until the next dose, then change to a new bag when dose is due.

Intermittent Curlin Pump

Gather Supplies:

  • (1) Bag of __________ (medication)
  • (2) Pre-filled syringes of Saline
  • (1) Pre-filled syringe of Heparin
  • Alcohol Prep Pads
  • Curlin tubing
  • (1) Blue sterile cover

Procedure:

  1. Wash hands thoroughly with liquid soap for at least 20 seconds and dry with paper towels
  2. Open curlin tubing package (IV tubing is good to use for 3 days)
  3. Break off tab on yellow piece of tubing.
  4. Remove tab from IV bag
  5. Remove cap from spike on tubing (be sure not to bump this against anything)
  6. Insert spike into IV bag by pushing and twisting until you reach lip on spike
  7. Remove air from tubing by holding bag up and squeezing yellow piece on tubing until fluid reaches bottom of tubing.
  8. Load tubing into pump by opening door on top of pump. Place pump on its side with the keypad facing towards you. Load blue piece on tubing into hole by the blue arrow in pump, then set pump upright and load yellow piece on tubing into hole by the yellow arrow in pump. Close door.
  9. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  10. Clean end of PICC line with alcohol swab for 10- 15 seconds
  11. Attach saline flush to PICC line
  12. Open clamp on PICC line
  13. Flush PICC line with saline flush
  14. Remove empty flush from PICC line and discard
  15. Clean end of PICC line with new alcohol swab for 10-15 seconds
  16. Remove cap from end of IV tubing and attach tubing to PICC line
  17. Turn Pump On. Pump will go through self-test. Then show how full batteries are.
    1. If batteries are less ¼ full, change these before starting. Batteries are changed in the back of pump. Slide door to unlock and then slide down. Pull batteries out and replace with (2) C batteries that face the same way.
  18. When pump reads “Program: – hit the YES button on the pump
  19. When pump reads “Repeat Rx” – hit the YES button on the pump
  20. Once pump reads through settings, hit the RUN button on the pump to start infusion
  21. When infusion is complete – Pump will beep and read “Infusion Complete.” Turn pump OFF
  22. Disconnect tubing from the end of PICC line and immediately cap with new blue sterile cover.
  23. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  24. Clean end of PICC line with new alcohol swab for 10-15 seconds
  25. Attach saline flush to PICC line and flush PICC line with saline
  26. Remove empty flush from PICC line and discard
  27. Prepare heparin flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  28. Clean end of PICC line with new alcohol swab for 10-15 seconds
  29. Attach heparin flush to PICC line and flush PICC line with heparin
  30. Close clamp on PICC line
  31. Remove empty heparin flush and discard

 

NOTE: Leave empty medication bag on the IV tubing until the next dose, then change to a new bag when dose is due.

Intermittent Readymed

Gather Supplies:

  • (1) Medication ball of ________ (removed from refrigerator 12 hours before use)
  • (2) Pre-filled syringes of Saline
  • (1) Pre-filled syringe of Heparin
  • Alcohol Prep Pads

Procedure:

  1. Wash hands thoroughly with liquid soap for at least 20 seconds and dry with paper towels
  2. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  3. Clean end of PICC line with alcohol swab for 10-15 seconds
  4. Attach saline flush to PICC line
  5. Open clamp on PICC line
  6. Flush PICC line with saline flush
  7. Remove empty flush from PICC line and discard
  8. Clean end of PICC line with new alcohol swab for 10-15 seconds
  9. Remove cap from end of medication ball and attach tubing to PICC line
  10. Open clamp on medication ball. (Check medication ball in approximately 15 minutes. You should notice that medication ball is visibly getting smaller and developing wrinkles and dimples along outside)
  11. When infusion is complete (medication ball should be flat)– Disconnect medication ball tubing from the end of PICC line and discard
  12. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  13. Clean end of PICC line with new alcohol swab for 10-15 seconds
  14. Attach saline flush to PICC line and flush PICC line with saline
  15. Remove empty flush from PICC line and discard
  16. Prepare heparin flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  17. Clean end of PICC line with new alcohol swab for 10-15 seconds
  18. Attach heparin flush to PICC line and flush PICC line with heparin
  19. Close clamp on PICC line
  20. Remove empty heparin flush and discard
IV Push

Gather Supplies:

  • (1) syringe of __________ (medication)
  • (2) Pre-filled syringes of Saline
  • (1) Pre-filled syringe of Heparin
  • Alcohol Prep Pads

Procedure:

  1. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  2. Clean end of PICC line with alcohol swab for 10- 15 seconds
  3. Attach saline flush to PICC line
  4. Open clamp on PICC line
  5. Flush PICC line with saline flush
  6. Remove empty flush from PICC line and discard
  7. Clean end of PICC line with new alcohol swab for 10-15 seconds
  8. Attach medication syringe to PICC line
  9. Push medication slowly over _____ minutes or _____ mL per ___________.
  10. When medication syringe is empty, remove from PICC line and discard.
  11. Prepare saline flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  12. Clean end of PICC line with new alcohol swab for 10-15 seconds
  13. Attach saline flush to PICC line and flush PICC line with saline
  14. Remove empty flush from PICC line and discard
  15. Prepare heparin flush by removing cap, pulling plunger back to break seal, and then pushing up to remove air from syringe
  16. Clean end of PICC line with new alcohol swab for 10-15 seconds
  17. Attach heparin flush to PICC line and flush PICC line with heparin
  18. Close clamp on PICC line
  19. Remove empty heparin flush and discard
Additional Educational Materials:
Emergency Readiness Plan

In the event of an emergency where you are unable to contact us within 24 hours, please be prepared to initiate the following:

 

Potential emergencies may include:

  1. Severe weather (blizzard, tornado, ice storm, etc.)
  2. Agency is inoperable (fire, flood, etc.)
  3. County emergency
  4. Civil disturbance

 

If unable to reach our office, contact our answering service directly at 315-475-1601.

How to Avoid the Flu
Infection Control

Do You Know??

Sneeze into a tissue or your elbow and cover your mouth when coughing. Avoid close contact with people who are ill.

 

Hand hygiene (cleansing)

Should be done any time you come in contact with an open wound or blood; before preparing food; after contact with uncooked meat and poultry; before eating; after changing diapers; after coughing, sneezing, blowing your nose or using the bathroom or prior to starting IV therapy. Hands should also be washed after removing gloves following any procedures.

 

Washing your hands

 

Alcohol based hand sanitizer for between washes or if no soap & water are available!

 

If your nurse has not performed hand hygiene, Speak Up!!

CNY Infusion Services logo
Joint Commision

Administrative Office

333 Butternut Drive
Suite 102
Dewitt, NY 13214

Office Hours

Mon - Fri — 8:30am - 5:00pm

Saturday - Sunday — Closed

24 hour, 7 days a week nursing and pharmacy support

Contact

Phone: (315) 424-7027

Toll Free: 1 (800) 591-9232

Email: info@cnyinfusion.com

Fax: (315) 424-7638