Running incompatible drips in different lumens of the same line... Thought??!

That's one of the main reasons you have different lumens.

That's one of the main reasons you have different lumens.

There is no concern for the meds to mix together when they leave the lumens and meet in the blood vessel?

There is no concern for the meds to mix together when they leave the lumens and meet in the blood vessel?

They meet in the vessel at different points

That's why you have 3 lumens.

It's not a worry with a regular central line, since they do terminate at different places. However, I have wondered this myself when we're talking about PICCs, where the lumens all open in exactly the same spot. I'm assuming the large amounts of blood around the PICC opening dilute the drugs quickly enough that they don't have time to react with each other.

I found this as well:

"PICCs with multiple lumens, or ports for infusing, can be used simultaneously for different purposes such as drawing blood, infusing medications or IV fluids, administering TPN, or monitoring central venous pressure. Therefore, with a triple lumen catheter, for example, three separate and distinct access lines are available with one cannulation. The risk of drug incompatibility is virtually non-existent as it is place in a large, central vein."

http://picclinenursing.com/picc_dev.html

Just about everything is compatible. Don't listen to pharmacy and all the people in your unit. I've ran every drip together with each other with no precipitate except for things like lasix, mannitol, bicarb, TPN. I don't care what someone says you CAN run all vasoactives plus your amnestics in the same line and there will be no harm. Not saying this is what you should do, but it will work and be okay.

Just about everything is compatible. Don't listen to pharmacy and all the people in your unit. I've ran every drip together with each other with no precipitate except for things like lasix, mannitol, bicarb, TPN. I don't care what someone says you CAN run all vasoactives plus your amnestics in the same line and there will be no harm. Not saying this is what you should do, but it will work and be okay.

Please tell me this is sarcasm? You absolutely should listen to pharmacy, your coworkers and of course micromedics.

Please tell me this is sarcasm? You absolutely should listen to pharmacy, your coworkers and of course micromedics.

Prove me wrong that these drugs are NOT compatible and don't just tell me it's because pharmacy tells you so. Show me actual evidence that they will precipitate or cause a reaction because I use them all the time together in anesthesia and use to use them all the time in the ICU.

Prove me wrong that these drugs are NOT compatible and don't just tell me it's because pharmacy tells you so. Show me actual evidence that they will precipitate or cause a reaction because I use them all the time together in anesthesia and use to use them all the time in the ICU.

If micromedics and the pharmacy tell me they aren't compatible, there's no way in hell I'm dumb enough to ignore them and mix them just for fun. If you do that in your practice then you are putting your patients lives in jeopardy. If I saw any nurse blatantly ignoring the pharmacys warning and mixing lines that explicitly state they are incompatible I would be reporting them to management and the BON faster than you can blink! There is a reason for the warnings and ignoring them is beyond stupid.

No not everything is compatible. I once saw a nurse hook up two incompatible drugs and the tubing quickly filled with a curdled mix looking substance!

If the PICC or other central line is placed properly, the end terminates in the correct place (SVC near entrance of the atrium), the blood flow should be so rapid and turbulent, that the infusions are mixed rapidly in the blood stream. This, there is not enough contact between the infusions for them to precipitate.

This is one reason, that if the PICC pulls out partially from the site, positioning is checked to insure that it is still a central access, not midline/peripheral.