I am anal about this topic aren't I??
Well, please help me understand. If I were to hang, for example, a piggyback, I always check to ensure that it is compatable with the primary. I use my IV drug book to check this.
But in my book, and on the big compatability chart that is hanging in the med room, it doesn't list common fluids with additives. Like, it doesn't list the KCL in , for example, D5.45 w/ 20 KCL (1000ml bag). The chart and book only lists the D5.45 compabality list. So how am I to know if my piggyyback is going to be compatable with the KCL?
Our administration is very helpful with this, since we hang a lot of antibiotics and a lot K and a lot of TPN and a lot of blood and platelets and...we just hang a lot.
We have a list of drugs commonly used on our unit that are compatible with TPN. I give this one a quick check to see if what I'm hanging is on there. If so, it will be compatible with D5, NS, Mag, Pot, Insulin, and a lot of other stuff that is commonly in TPN.
If it's not on this list, and I need to piggyback something on a fluid other than the one the piggyback is mixed in or if the flush/fluid line is connected to another line (such as a morphine drip), I check our computer program, Micromedix. If I can't get an answer there or from pharmacy, I will stop a line until whatever I need to hang has run in.
I recently tried to give an IV push of Ativan. I checked if it was compatible with IV fluid on the primary and it was, but I didn't check if it was compatible with the IV piggyback of antibiotic that had recently run in and it started to precipitate. It actually wasn't that big of a deal. I just stopped pushing the Ativan, made sure the piggyback line was wheeled off, ran some fluid in fast to push the antibiotic through and then finished the push. You will see when something precipitates, so always look at your lines.
Last edit by firstyearstudent on Oct 30, '07