CHANGEOUT ENTIRE BRIDGE

Established: 2013

Revised Nov 2013

PURPOSE
To replace clotted or faulty bridge tubing.

SITE APPLICABILITY
Applicable to all patients within BCCH on an ECLS circuit with a bridge intact.

PRACTICE LEVEL/COMPETENCIES
ECLS is considered an advanced skill and only those with advanced training in ECLS are to perform this
task.

Perfusionist

EQUIPMENT
1. 2 Y connectors
-For 3/8 circuit: 3/8 x 3/8 x Y with luer lock and one without
-For circuit: x x Y with luer lock and one without
2. 60ml syringe filled with crystalloid
3. Sterile tubing segment.
4. Clamps X 6
5. Sterile Scissors
6. Sterile towels
7. 2% chlorhexidine gluconate with 70% alcohol swabs (CHG/alcohol)

PROCEDURE
1. Prepare sterile field
2.

3.
4.

5.

Elevate old bridge segment above sterile field and clean tubing with CHG/alcohol.
Lower old bridge segment to sterile field.
Prepare new bridge segment with both the venous and arterial Y connectors inserted into the new
bridge tubing.
Connect pigtail to the luer lock connector of the venous line Y connector on the new bridge segment.

6. Attach 60ml crystalloid syringe to the pigtail.

7. Separate the patient from the ECLS circuit as per routine and start timer.
8.

9.

Clamp above and below the venous line Y connector and clamp the old bridge tubing segment.
Use the sterile scissors to remove the old venous line Y connector and insert the new venous line Y
connector with the attached new bridge segment, into the venous line.

10. Using the 60 cc syringe and pigtail, prime the venous Y connector and new bridge tubing segment up
to the arterial Y connector.
Note: If patient unstable, clamp bridge and go back on support to rest patient.
11. If patient stable or after rest period continue with procedure.
Policy #

BCCH Child & Youth Health Policy and Procedure Manual

Page 1 of 2

CHANGEOUT ENTIRE BRIDGE

Established: 2013

Revised Nov 2013

12. Clamp above and below the old arterial line bridge Y connector.
13. Use sterile scissors to remove the old arterial line Y connector and insert one end of the new arterial
line Y connector, with the new bridge segment attached, into the ECLS circuit arterial line.
14. Use the 60 cc syringe and pigtail to prime the new arterial line Y connector and spill prime into the
unattached circuit arterial line segment until de-aired.
15. Insert the open end of the arterial line Y connector into the circuit arterial line segment and ensure that
no air remains with in the connection point.
16. Clamp the new bridge and then reinitiate ECLS support as per routine, stop timer and document
17. Clamp the pigtail, remove the 60cc syringe, attach the DLP pressure isolator to the pigtail and then re
zero the venous line DLP pressure box as per routine.

DOCUMENTATION
Chart all ECLS parameters on ECLS flow sheet.

REFERENCES

Policy #

BCCH Child & Youth Health Policy and Procedure Manual

Page 2 of 2