[studentIVlife]

hello I am a new CNA eventually going for my RN. I have heard piggyback what does this mean? Is it two fluids running together at the same tube? Also what does compatibility mean? For ex. if two drugs are compatible do you run both at the same time to go in in one tube in the patients arm? I thought I noticed the nurse shut off the 1st IV and then give the other medication so why look for compatibilities. Sorry for my ignorance.

[MoopleRN]

The piggy back is a medication that runs in a maintenance line. While the piggy back is infusing, the other solution is stopped even though it's still connected to the IV. When the piggy back has run through, the pump will automatically kick over and begin infusing the maintenace fluid (often running at a much slower rate). The two need to be compatible because the solutions will meet in the IV tubing.

[studentIVlife]

thanks so much, if you don't mind I have another quetion. What if the piggyback wasn't compatible. What can happen? I heard something like precipitation but what does that do? Can it kill the patient?

[ranaazha]

Originally Posted by studentIVlife

thanks so much, if you don't mind I have another quetion. What if the piggyback wasn't compatible. What can happen? I heard something like precipitation but what does that do? Can it kill the patient?

If two fluids are incompatible, they will "fight" each other OR clump together and form a "precipitate." A precipitate is like the spots that are left on your dishes. Imagine that stuff being clumped up in a person's veins! So, yes, it can kill someone!

If a patient has a standard peripheral IV, and you're infusing something that's incompatible with an IVPB, then you disconnect it (or just make sure it's turned off & the port is flushed), and hang a small bag (like 250cc) to run after the IVPB. Once you hear the alarm sound that the infusion is finished, you reconnect or turn back on the original fluid.

Most people aren't receiving a standard infusion of something that's incompatible, though. Most people are receiving NS or D5-something or other.

If someone has a PICC line, though, that changes the situation. Although it appears similar to a peripheral IV in that there are 2 (or 3) ports, the line is longer (something like 1 foot compared to 1 inch) with multiple exit points. With those, you can run 2 incompatible fluids because they will exit at different spots in the superior vena cava, therefore being mixed directly with the venous blood instead of with each other.

[studentIVlife]

Ranaa... thanks for your great information. SO if I was running a primary IV fluid and then stoped it to run the IVPB it's ok to flush it before restarting the IV primary? I just want to make sure I understand what you are saying. SO flushing it is enoght to clear the line. Sorry so many questions I am not a nurse yet.

[ranaazha]

Originally Posted by studentIVlife

Ranaa... thanks for your great information. SO if I was running a primary IV fluid and then stoped it to run the IVPB it's ok to flush it before restarting the IV primary? I just want to make sure I understand what you are saying. SO flushing it is enoght to clear the line. Sorry so many questions I am not a nurse yet.

I look at it this way: You can never flush enough (unless you're dealing w/ CHF or fluid overload). If you run an IVPB that's an antibiotic, for example, and you set the primary to run after the abx is finished, then you're achieving the same "flush" that you would w/ a 10cc NS syringe, the machine is just doing the work for you. I always set my primaries (if I'm only using them to flush after an IVPB) to rate of 100 w/ volume of 10. So it's like a slower 10cc flush. Same effect, slightly longer period of time.

If your primary fluid is compatible w/ the IVPB, then flushing isn't necessary because, once the primary restarts, it will "flush" in addition to doing whatever it's set up for. That being said, YES, flushing is enough to clear the line because that's exactly what you're doing: Clearing the line. If you don't have a primary fluid running, you should flush (either w/ the pump or w/ a syringe) after the IVPB finishes simply to clear the port & the vein.

[studentIVlife]

thanks for this great advice. I will carry this on with me. thanks sooooooo much.