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How to Set Up and Infuse Your TPN

Important: Do not change any of the supplies listed here.

Keep supplies away from children.

Only your home care nurse or persons trained by Fairview

Home Infusion may give you IV medicines. If an untrained
person gives you IV medicine, this could cause serious
problems, including death. Call your nursing service if
someone needs training.

Use these instructions with every infusion.

If you have any problems with your infusion, please call us.
Fairview Home Infusion

612-672-2233 or 1-800-642-8845

If you are deaf or hard of hearing, please let us know. We provide many free services including
sign language interpreters, oral interpreters, TTYs, telephone amplifiers, note takers and written materials.
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Getting ready 3. Gather these supplies:

1. Remove the TPN bag from the refrigerator 6 to 8 a. IV tubing with 1.2 micron filter
hours before use. This allows time for the contents
b. TPN/Lipid bag at room temperature
to warm up to room temperature. Do not warm
the bag in the microwave, with direct sunlight or c. CADD pump, instructions and 4 AA batteries
hot water. Let it warm up naturally.
d. Two syringes of 0.9% sodium chloride
2. Read the label on the TPN bag. Check for your (saline solution)
name and the discard, or use-by, date. If the
e. One syringe of Heparin Lock Flush (if needed)
date has passed or any part of the label is wrong,
do not use the TPN. Call your Home Infusion f. Alcohol pads, thermometer
pharmacy team.
4. Wash your hands well for 15 seconds. Use liquid
soap or hand foam if your nurse suggests it.
Remember:
1. Wash your hands before touching supplies.
5. Check your temperature and record it.
2. “Scrub the hub”—Clean the end cap on your
IV line for 15 seconds before connecting to it.

Gather these supplies to set up and infuse your TPN

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� Adding insulin or vitamin K to the TPN � Adding vitamins to the TPN bag
bag (add before multi-vitamins)
1. Gather these supplies:
1. Gather these supplies: • Alcohol pads
• Alcohol pads • Two vials of vitamins with caps of
• Prefilled insulin syringe and one-inch (22 different colors.
gauge) needle that came with the syringe • Two 10-ml syringes with needles
• Prefilled vitamin K syringe and the needle that • TPN bag
came with it in the brown plastic bag
• Your TPN bag

If you are adding insulin and vitamin K, add the

insulin first.

2. Wash your hands well for 15 seconds. Use liquid

soap or hand foam.

3. Read the label on the syringe. Check to be sure

your name, the medicine name, and the dose are
correct. Also check the discard, or use-by, date. If
the date has passed or any of the information is
wrong, do not use the syringe. Call your Home
Infusion pharmacy team.

4. Take the plastic cover or rubber tip off the Supplies for adding vitamins to your TPN
syringe. Do not touch the tip.

5. Attach the needle to the syringe by twisting it on. 2. Wash your hands well for 15 seconds. Use liquid
soap or hand foam.
6. With a fresh alcohol pad, scrub the short rubber
or plastic port at the bottom of your TPN bag. 3. Open one vial.
Scrub for 15 seconds and let air dry.
4. Use a fresh alcohol pad to scrub the top of the vial.
7. Take the cover off the needle by pulling it Scrub for 15 seconds and let air dry.
straight off. Do not twist it off and do not touch
5. Use a fresh alcohol pad to scrub the short rubber
the needle.
or plastic port at the bottom of your TPN bag.
8. Insert the needle into the port. Inject (push) all Scrub for 15 seconds and let air dry.
of the liquid into the bag. Remove the needle and
6. Take the cover off one of the needles by pulling it
syringe from the port.
straight off. Do not twist it off and do not touch
9. Throw the empty needles and syringes into your the needle.
sharps container.
7. Draw back the plunger to fill the syringe with 5
10. If you are adding vitamin K, repeat steps 3 to 9. ml air. For children’s multivitamins, follow your
nurse’s instructions.
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8. Use the tip of the needle to pierce the center of � Mixing lipids and TPN
the opened vial. Push all the air into the vial.
If your TPN bag has a lipid chamber (with white,
9. Keep your thumb on the plunger of the syringe. milky liquid), check these things before using it:
Turn the vial upside down, and then withdraw all
the liquid from the vial. • The white liquid at the top should look like milk,
without brown streaks or cracking.
10. Tap the side of the syringe, moving any air
bubbles to the top. Inject these back into the vial. • The liquid at bottom will look clear or slightly
This way, you will make sure that all the air is out yellow. It should not look murky or milky or
of the syringe. It’s okay to have tiny bubbles on the contain any solid pieces.
inside of the syringe.
• If you notice anything unusual, do not use the
11. Remove the needle and syringe from the vial. TPN. Call your Fairview Home Infusion team.

12. Insert the needle into the center of the port. Push After you complete the above checks, mix the two
all of the liquid into the bag. Remove the needle chambers. Do this just before hooking up your TPN
and syringe from the port. for the day:

13. Throw the empty needle and syringe into your 1. Pull on the rubber tube, then pull the silver strip
sharps container. from between the two chambers.

14. Take up the second syringe and vial. 2. Gently knead the bag until the liquids are well
Repeat steps 3-13. mixed. Once mixed, TPN is only good for
24 hours.

Pull the silver strip from between the

two chambers
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Attaching the tubing CADD pump setup and operation; priming

your tubing
1. Remove the IV tubing from its package. Pull the
blue clip from the cassette, then tear off the white 1. Make sure the pump is stopped and powered off.
paper strips. Using your fingers, the pump key or a coin, turn
the knob on the battery door counterclockwise
2. Holding the TPN bag, remove the seal from the
to open the battery door on the top of the pump.
large middle port at the bottom of the bag. Once
Note: If the batteries are already in place, go to
the seal is removed, do not touch or clean the
step 4.
open port. Do NOT use the clamped port.
2. While holding the pump at an angle, place 4 AA
3. Take the cover off the tubing spike. Push and twist
batteries in the pump from the bottom up. Match
the spike into the middle port of the bag.
the + and – markings on the batteries with the
markings on the pump.

Insert AA batteries from the bottom up,

Twist the spike into the middle port
matching the + and- markings

3. Using your fingers, the pump key or a coin, close

the battery door by turning the knob on the
battery door clockwise.

4. Press and hold the power switch to turn the

pump on.

5. The pump will beep after completing self-

tests and “Ready To Begin” will appear on the
home screen.
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6. Open the cassette latch to a 90 degree angle. 10. Make sure the cassette is attached correctly.
The top of the cassette should line up evenly with
the bottom of the pump and be securely attached.

11. If the screen says “Reset Reservoir volume to

____ ml” select Yes. The pump will reset to the
volume needed to run your TPN for the day.

12. “Prime tubing?” will appear on the home screen.

Select Yes.

13. “Disconnect tubing from patient, open clamps,

then press ‘Prime’” appears on the home screen.
Select Prime. Let the filter hang straight down
while priming.

Open the cassette latch to a 90° angle 14. When the liquid reaches the end of the tubing,
select Stop priming. If “Continue priming”
7. Attach the TPN tubing cassette to the pump by appears on home screen select No.
connecting the hooks on the cassette to the hinge
pins on the bottom of the pump.

8. Place the pump on a firm, flat surface and press

down on the cassette so it fits tightly against
the pump.

9. Lift the cassette handle into the closed position.

Let the filter hang straight down

List the cassette handle into the

closed position
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15. “Start infusion” will appear on the home screen. 5. Double check that the reservoir volume on the
Select No. screen matches the res vol on your TPN label.
If the reservoir volume on the screen and Res
16. At this point, make sure that the Reservoir Vol on your TPN label match, you are ready for
Volume number in the left corner of the status “Connecting and infusing TPN.”
bar at the top of the pump screen matches the
number on the TPN label. The bag label will say Warning: If the reservoir volume on the screen
“Res Vol” instead of Reservoir volume. still does not match the Res Vol on your TPN label,
STOP. Do not infuse your TPN bag. Call your
Fairview Home Infusion team.

Connecting and infusing TPN

You are now ready to hook up and start your TPN.

1. Set the pump and TPN bag aside.

2. Use a fresh alcohol pad to scrub the end cap on

your IV line. Scrub for 15 seconds and let air dry.

3. Open the clamp on your IV line, if you have one.

“Pulse” flush your IV line with one syringe of
0.9% sodium chloride.

4. Use a fresh alcohol pad to scrub the blue cap on

The Reservoir Volume number is in the top your IV line again. Scrub for 15 seconds and let
left corner of the pump screen air dry.

5. Twist the plastic cover off the end of the TPN

Note: If the Reservoir volume does not match the tubing. Do not touch the end of the TPN tubing.
Res Vol on your TPN bag, see “Reset reservoir Insert the tubing into the blue cap on your IV
volume by hand” below. Otherwise go to line. Twist to secure the tubing, just like your
“Connecting and infusing TPN.” nurse showed you.

Reset reservoir volume by hand 6. Begin the infusion.

1. Select Tasks. • Press the stop/start button. “Start pump?”

appears on the screen. Select Yes.
2. Select Reset Reservoir Volume.
• The word “Running” will appear in the status
3. “Reset reservoir volume to ____ml?” will appear bar at the top of the pump screen and the green
on the home screen. Select Yes. light will blink while the pump is infusing.
4. Select Back to return to the home screen.
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Note: You can stop the infusion anytime the pump is

in KVO rate.

To disconnect...
1. When you are ready to disconnect, press the
stop/start button. “Stop infusion?” will appear on
the screen.

2. Select Yes. “Stopped” will appear on the status bar

at the top of the pump screen, and the amber light
will blink.

3. Close the clamp on your IV line if you have one.

“Running” appears in the status bar at
the top of the pump 4. To remove the TPN tubing from your IV line,
hold the blue cap and twist off the tubing.
7. One (1) hour after you start the TPN, take your
temperature and write it down. Call Fairview 5. Use a fresh alcohol pad to scrub the blue cap on
Home Infusion if your temperature is 2 degrees your IV line. Scrub for 15 seconds and let air dry.
higher than your baseline temperature or if you
6. Open the clamp on your IV line if you have one.
have chills while infusing.
“Pulse” flush your IV line with one syringe of
0.9% sodium chloride.
End of infusion
7. Before you remove the empty syringe, close the
Your nurse will tell you how many hours your TPN
clamp if you have one. Go to step 9 unless you
will run.
are using heparin.
When your TPN infusion is done, the pump will
8. If you were told to flush with heparin:
alarm and “Reservoir volume low” or “Infusion
complete” will appear on the screen. • Scrub the end cap on your IV line for 15
seconds with a fresh alcohol pad. Let it air dry.
• If “Reservoir volume low” is on the screen, • Twist the syringe of heparin into the end of
select Acknowledge. “Infusion complete” will your IV line.
appear on the screen. Select Acknowledge.
• Open the clamp on the IV line if there is one.
• If “Infusion complete” is on the screen, select • “Pulse flush” your IV line with one (1) syringe
Acknowledge. of Heparin Lock Flush.
If you don’t disconnect now, the pump will switch • Before you remove the empty syringe, close the
by itself to KVO rate (very slow). It will stay at this clamp if you have one. Then hold the end cap
rate until you are ready to disconnect, or until the and twist off the syringe.
reservoir volume reaches “0.”
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9. Remove the tubing cassette from the pump by

pushing down on the cassette latch until the
cassette unlatches.

Push down on the cassette latch until

the cassette unlatches

10. Press and hold the power switch to turn the pump
off. “Power down?” will appear on the screen.
Select Yes. Do NOT turn the pump off before you
remove the tubing cassette.

11. Open the door to the battery compartment and

remove the batteries.

12. Throw your used supplies in the trash, including

the batteries.
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For informational purposes only. Not to replace the advice of your health care provider.
Copyright © 2006 Fairview Health Services. All rights reserved. SMARTworks 520258 – REV 12/16.