How do you define "piggyback"?

[MunoRN, RN]

I've noticed there is a wide range of definitions for "piggyback" where I work, which is sort of a problem since our IV policies refer to "piggyback" IV's numerous times.

Is it just where I work, or is there a more universally agreed upon definition out there?

[Testa Rosa, RN]

To me it's anything running thru the secondary set thru the pump, with the primary being the base hydrating fluid (ie, normal saline or D5 or some specialty elyte mix from the pharmacy).

[MissKayRN]

At my facility we basically refer to piggybacks as anything (usually IV antibiotics) that doesn't run continuously. For example - Levaquin that is given once daily.

[MunoRN, RN]

Testa Rosa, RN said:

To me it's anything running thru the secondary set thru the pump, with the primary being the base hydrating fluid (ie, normal saline or D5 or some specialty elyte mix from the pharmacy).

Which brings up a related question: What is a secondary? I've always believed that a secondary is by definition intermittent, so is it possible to have a "continuous secondary"?

[msjellybean]

MunoRN said:

Which brings up a related question: What is a secondary? I've always believed that a secondary is by definition intermittent, so is it possible to have a "continuous secondary"?

I run continuous chemo on a secondary line.

[MunoRN, RN]

msjellybean said:

I run continuous chemo on a secondary line.

Do you run it on it's own pump? Are you y'ing it in to another line above or below the other pump?

[Belle Epoque]

It's called piggyback because it is given on top of the primary IV solution (NS, LR) and hung higher to allow for intermittent infusion and once finished, switches back to the primary. So no, not possible to have a continuous secondary.

I've heard places call IVP piggyback (because it's also intermittent) but that confuses the heck out of things.

[msjellybean]

Yes, the chemo gets its own pump. And the primary in that instance is usually nothing more than plain IVF set at TKO, mainly used just to prime the tubing with.

Depending on how many lines the pt has available, sometimes we will y in. Had a pt last night with a double lumen PICC, getting continuous Ara-C, continuous pca + IVF & q6 abx. Ideal situation. Had another pt a few weeks ago that was getting three different agents (two of which were continuous, but can't for the life of me remember what they were). She only had a port. Somehow, they were all compatible, so they all got y-ed into each other. They all still had their own pumps of course.

[ObtundedRN, BSN, RN]

Piggyback is anything that is attached to the main IV line. The Main IV line usually has your maintance fluid in it. And the piggyback is your secondary line. Either Y'd together and hung by gravity, or attached the secondary port on a pump. If I was to hang an intermittant drug without another fluid, then I would have to put it on a primary line. In that case, I wouldn't call it piggyback since it is the main fluid.

Its called piggyback because it "rides" along on the main line.

[MunoRN, RN]

msjellybean said:

Yes, the chemo gets its own pump. And the primary in that instance is usually nothing more than plain IVF set at TKO, mainly used just to prime the tubing with.

Depending on how many lines the pt has available, sometimes we will y in. Had a pt last night with a double lumen PICC, getting continuous Ara-C, continuous pca + IVF & q6 abx. Ideal situation. Had another pt a few weeks ago that was getting three different agents (two of which were continuous, but can't for the life of me remember what they were). She only had a port. Somehow, they were all compatible, so they all got y-ED into each other. They all still had their own pumps of course.

If its on its own pump, do you program the chemo into it's pump as primary or secondary?

[MunoRN, RN]

ObtundedRN said:

Piggyback is anything that is attached to the main IV line. The Main IV line usually has your maintance fluid in it. And the piggyback is your secondary line. Either Y'd together and hung by gravity, or attached the secondary port on a pump. If I was to hang an intermittant drug without another fluid, then I would have to put it on a primary line. In that case, I wouldn't call it piggyback since it is the main fluid.

Its called piggyback because it "rides" along on the main line.

So you'd call a line y'd in either above or below the pump a secondary?

[Perpetual Student]

MunoRN said:

If its on its own pump, do you program the chemo into it's pump as primary or secondary?

If it's on its own pump you would set it as a primary. On the pumps we use if you set up an infusion as a secondary without a primary infusion set on that pump it won't work.

With the pumps we use you can indeed program it to have concurrent administration of your primary and secondary lines on one pump.