The event occurred on an unspecified date and involved a 60" (152 cm) appx 1.8 ml, smallbore ext set w/remv microclave® clear, clamp (blue), luer lock.The reporter stated a patient's manifold was primed in the operating room with the substitution tubing and the clear caps were removed off each of the lines.The tubing is 1.8 and bigger than the continuous tubing they usually use for manifolds.The bedside nurse stated there was blood backing up into the manifold.After trying to trouble shoot the pumps and increasing the carrier to 5ml/hr to attempt to clear the line, the nurse ultimately had to disconnect the line closest to the patient to assess if the line was clotted.Once she disconnected the line a lot of fluid expelled from the manifold.The bedside nurse was instructed to push the normal saline carrier through the manifold to clear the blood.After she stopped putting pressure on the back of the syringe, the manifold sucked in air.Staff has had issues with this substitute tubing backing up air after pressure is released from the back of the syringe.Ultimately they were able to clear the manifold and line with continuous pressure on all of the syringes.The patient was on epinephrine at 0.04, amiodarone and milrinone, because they had to interrupt the stead state, they had to increase her drips and call the intensivist to bedside due to her hypotension.Due to this issue the bedside nurse ended up priming a whole new manifold with the continuous tubing we usually use for manifolds.The affected product was not saved.There was patient involvement and no report of patient harm.
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