Why does a cardizem drip need to be on its own line, as opposed to piggybacked into a bag of 0.9ns?
Especially if the drip is going at 5 or 10cc/hour, I was taught (somewhere) that you need to piggyback and make sure the total drip rate is at least 10 or 20 cc/hour. (I think, again, this is all hearsay from previous jobs).
CCU nurses, what say you?
Not sure I understand how you had it piggybacked and recently ran into a similar situation with a new grad and a K+ rider, so I'll try to explain why:
If you run the Cardizem as a true piggyback and the NS is the primary line, there is the danger of having the pump change the rate from the 5 mg/hour for say, 100 cc's, back to the PRIMARY rate of say, 80 ml/hour. This happens when you set up the volume on the piggyback bag. You set it for 100 ml total volume, but sometimes the piggyback bag has more in it than 100 mls, so what you wind up with is the last few mls of Cardizem going in at the primary rate -- way too fast for a drip.
This is what happened to me the other day. I came upon a K+ rider that had a few cc's left in it, going at 80 ml/hour, which was the primary IVF rate. But K+ protocol in our facility is that it can't go faster than 50 ml/hour, especially through a peripheral, so I had to stop it immediately.
I tend to use the NS on a dial-a-flow or gravity drip, then I have the Cardizem going on the pump. I plug the Cardizem into the IVF line below the pump, at the port nearest the patient's IV site. That way, the patient gets a true 5 mg/hour, and not the other fluid's rate by accident.
I hope that all made sense.
Last edit by UM Review RN on Apr 27, '07
I would think that the problem with piggybacking would be that you're ONLY running at the secondary rate... so nothing is going out of the primary bag. In contrast, when you run them on 2 pumps, then you're getting the NS at say 25cc/hr at the same time as the Cardizem at 5cc/hr, thus resulting in a total of 30cc/hr, rather than just 5cc/hr if you were doing a piggyback.
Not to mention the problem that Angie brings up... you'd end up pushing a whole line full of Cardizem once you're primary kicks in at the end at a faster rate if you're running a classic piggyback setup.
Last edit by Dakkon76 on Apr 28, '07