Spiking Your IV Bag

You will need to attach a tubing to your IV bag in order to infuse your solution or medication. This is called “spiking” the bag. Follow your healthcare provider’s instructions for how often you should use new tubing. In general, if you are infusing continuously, you should change your tubing every three days (except for TPN; that is changed every time you hang a new bag.) If your infusions are intermittent, (meaning they are interrupted and you are not infusing for a period of time – even a few hours) then you should change your tubing every 24hrs. You will always use a separate tubing if you are infusing different medications.

  1. Wash your hands.
  2. spiking-your-bag-001Gather your supplies.This should include your IV bag and tubing.
  3. Always check your medication label, making sure the information is correct – your name, name of the medication, dosage, expiration, etc. If there are any discrepancies, call us immediately.
  4. Your IV bag may be in an outer plastic covering. If so, peel off the outer packaging.
  5. spiking-your-bag-003 spiking-your-bag-002The IV bag will typically have two “ports” at the bottom. These will look like small pieces of tubing that are part of the IV bag. One is used to inject medications into the bag and has a beige stopper on the end. This stopper does not come off. You will not be using this one. You will be using the IV tubing port.
  6. spiking-your-bag-004 spiking-your-bag-005The cap of the IV tubing port pulls off. It may be blue or clear plastic. This is the port you will use to insert the end of the tubing. Hang your bag on the IV pole and pull off the cap. (Don’t worry, the fluid will stay in the bag!) Do not let the tip of this port touch anything else once the cap is off.
  1. Open the package with the IV tubing.
  2. spiking-your-bag-006You will see a roller clamp on the tubing. It will be open. Slide the roller to the bottom until it pinches the tubing. That is the “off” position.
  3. spiking-your-bag-007Some types of tubing have a pinch clamp instead of a roller clamp. If this is the case, pinch the clamp closed.
  4. Identify the end of the tubing that attaches to the IV bag. The drip chamber will be on that end. This is the part of the tubing where you can watch the fluid dripping.
  5. spiking-your-bag-008Remove the plastic cap that is on the end of the tubing. This exposes a plastic “spike.” Do not let the “spike” touch anything once you have removed the cap. It should stay sterile, as it will go into the IV bag. (Note: There may be a vent on the drip chamber. Do not manipulate that; it is not necessary for your type of therapy.)
  6. spiking-your-bag-009While holding the port on your IV bag with your non-dominant hand, insert the spike. It will take some pressure, and you should continue to insert it until it will go no further.
  7. spiking-your-bag-014Squeeze the drip chamber a few times until it is 1/3 – 1⁄2 full of fluid.
  8. spiking-your-bag-011Remove the cap on the other end of the tubing. Don’t throw this away, as you will need to replace it momentarily. It is important that the end of the tubing not touch you or any other surfaces. It will attach to your IV access and must remain sterile.
  9. spiking-your-bag-012Now open the roller clamp on the tubing with one hand while holding the tip of the tubing with your other hand. You may want to hold this over a receptacle. Watch the fluid come out the end – when the air is out of the line you may close the roller clamp. Removing the air from the line is called “priming” your tubing. A few “champagne bubbles” in the line is fine, however, you should not have large bubbles in your line. Keep running the fluid through the line until they are gone.
  10. spiking-your-bag-013If you have bubbles 1⁄2 inch or larger, keep running fluid through the line until they are gone.
  11. Replace the cap on the end of the tubing. You are now ready to flush your IV access (see instructions) and infuse your medication.