USC Anesthesia Sub-I
Prepare the room
Photo lesson · 7 steps · ~4 min

Spike and prime a fluid bag

A bag of the right fluid, spiked, chamber filled and the line fully de-aired, hanging and ready for your resident.

Find supplies
What you need (3)
Fluid bag (usually 0.9% NaCl or LR 1 L — ask)BD Alaris pump infusion set (REF 2420-0007)Extension set if your resident uses one
0 of 7 steps done
  1. 1 / 2
    1Step 1 of 7 LA General workflow

    Grab the bag and the tubing

    Do
    Take one fluid bag from the blue bins and one administration set.
    Why
    Pump sets and gravity sets are not interchangeable — the Alaris pump needs its own set.
    Check
    Right fluid, not expired, solution clear, outer wrap intact. Set matches the pump.
  2. 2Step 2 of 7 Standard practice

    Unwrap both

    Do
    Remove the bag from its overwrap and uncoil the tubing. Leave the spike cap and the distal end cap on.
    Why
    Those two caps keep the sterile ends clean until you need them.
    Check
    Squeeze the bag gently — no leaks.
  3. 3Step 3 of 7 Standard practice

    Close the clamp first

    Do
    Roll the roller clamp down (or slide it shut) before you spike.
    Why
    An open line drains the chamber and floods the tubing with air and fluid the moment you spike.
    Check
    Clamp fully closed.
  4. 1 / 3
    4Step 4 of 7 Standard practice

    Expose the port and spike the bag

    Do
    Pull the blue tab off the bag’s administration (spike) port — the longer one. Take the cap off the spike without touching the tip, then push it in with a firm twist until fully seated.
    Why
    The other, rubber port is the medication injection port — don’t spike it.
    Check
    Spike fully seated, nothing touched, no drip at the port. Touched the spike? Get a new set.
  5. 1 / 2
    5Step 5 of 7 LA General workflow

    Fill the drip chamber about halfway

    Do
    Hang the bag and squeeze the drip chamber until it is ⅓–½ full (or to the fill line if the set has one).
    Why
    Too low lets air into the line; too full and you can’t see the drops.
    Check
    Fluid level visible, about halfway — like the second photo.
  6. 1 / 2
    6Step 6 of 7 Standard practice

    Open the clamp and prime the line

    Do
    Open the clamp and let fluid run the full length into the trash or a basin. Invert and tap each Y-site and port as fluid passes. Close the clamp.
    Why
    Air in the line can reach the patient. Priming pushes it out.
    Check
    No bubbles anywhere — including side ports and any extension. End cap back on.
  7. 7Step 7 of 7 LA General workflow

    Hang it, ready to connect

    Do
    Hang the bag on the IV pole by the machine, with an extension attached if your resident uses one. Coil the line so the capped end stays clean and off the floor.
    Why
    It’s ready to connect the moment the IV is in.
    Check
    Bag labeled and visible; capped end protected.
    Say
    “Fluids are spiked and primed — normal saline on an Alaris set.”

Common errors

  • Spiking the medication (injection) port
  • Overfilling the drip chamber
  • Leaving the clamp open while spiking
  • Missing air trapped in a Y-site
  • Letting the end cap touch the floor (replace the set)

Teach it back

Teach-back
Why does a half-full drip chamber matter?
Answer
You can count drops, and if the bag runs low the remaining fluid in the chamber protects against air being drawn into the line.

Compare with the finished setup

The whole morning setup. Your resident and the case decide the final equipment.

Done with this part?

Mark it prepared in your room checklist, then review it with your resident.

Next: Airway setup
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