Total Parenteral Nutrition (TPN)

Summary

This video demonstrates the process of preparing Total Parenteral Nutrition (TPN), highlighting the importance of aseptic technique, safety protocols, and accurate preparation. The presenter walks through the preparation of two phases: the protein phase and the lipid phase. Key materials like amino acids, KCL, calcium gluconate, and lipids are used, with step-by-step guidance on their proper mixing and handling. Emphasis is placed on maintaining stability and ensuring the correct method for creating both phases of the TPN mixture, ultimately combining them for the final product.

Takeaways

• 😀 Operators must master aseptic techniques for preparing Total Parenteral Nutrition (TPN), including proper handling of ampoules and liquid transfer.
• 😀 Complete personal protective equipment (PPE) is essential for ensuring the safety of the operator during the preparation process.
• 😀 It's crucial to turn on all necessary equipment and machines before starting the TPN preparation to ensure compliance with protocols.
• 😀 Two primary phases are created when preparing TPN: the protein phase and the lipid phase. Each phase requires specific ingredients and careful handling.
• 😀 The protein phase is typically composed of amino acids, such as a 100 ml solution, and is mixed using aseptic techniques.
• 😀 Potassium chloride (KCL) is added to the protein phase, with careful attention to avoid bubble formation, which could affect the stability of the solution.
• 😀 Calcium gluconate is added to the protein phase, with exact measurements taken, and aseptic techniques are maintained throughout.
• 😀 The lipid phase is prepared separately, usually with a 20% lipid solution. Proper measurements must be taken based on the available formulation.
• 😀 Vitamins, such as fat-soluble ones, can be added to the lipid phase as needed, depending on the doctor’s prescription.
• 😀 Once both phases are prepared, they can be mixed together. Careful blending is necessary to ensure the stability of the final TPN mixture.

Q & A

What is the main process demonstrated in the video?

The video demonstrates the process of preparing Total Parenteral Nutrition (TPN), specifically focusing on aseptic techniques for mixing and handling various ingredients such as amino acids, electrolytes, and lipids.

Why is aseptic technique emphasized in this process?

Aseptic technique is emphasized to ensure that the preparation of TPN is done safely, preventing contamination that could lead to infection or instability in the final mixture.

What is the first step in preparing TPN?

The first step is ensuring the operator is skilled in aseptic dispensing techniques, including the proper way to break ampules and handle liquids, and preparing the necessary equipment for safety.

Why is it important to activate the equipment and machines before starting?

Activating the equipment and machines beforehand is important because certain steps and safety measures need to be followed before proceeding with the preparation of TPN.

What are the two phases involved in the mixing of TPN?

The two phases involved are the 'weak phase' and the 'protein phase' or amino acid phase. These phases are mixed separately before combining them.

What ingredients are required for the protein phase?

For the protein phase, the ingredients include 100 ml of amino acids, 20 ml of KCL (potassium chloride), 1 ampule of calcium gluconate, and 5 ml of sodium chloride (NaCl).

Why is it important to add KCL to the protein phase gradually?

KCL should be added gradually because if it is injected directly into the liquid, bubbles may form, which could disrupt the stability of the solution.

How is the lipid phase prepared?

The lipid phase is prepared by taking 100 grams of lipid solution and calculating the appropriate amount needed, which is 50 ml if using a 20% solution, and mixing it with fat-soluble vitamins as per the doctor's prescription.

Can water-soluble vitamins be added to the lipid phase?

Yes, water-soluble vitamins can be added to the lipid phase, although the process typically involves adding fat-soluble vitamins to this phase.

What should be done after combining both phases?

After combining the protein and lipid phases, the final mixture should be gently shaken to ensure thorough mixing before being administered to the patient.