IV compatability again
- 0Oct 29, '07 by raindropI 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?
- 0Oct 30, '07 by nurseabc123Quote from raindropMost IV incompatabilities refer to physical incompatabilities, ones that are going be more so extra work the nurse to fix than actually harm a patient. For instance, insulin and hydralazine are incompatable - forming a white precipitate in the tubing. Ok, no harm done. Flush your tubing start all over again. It's great your checking your iv compatabilities (and I always do when I am unsure as well), but I wouldn't get worked up over it.KCL is compatable with any antibiotic, too???
- 0Oct 30, '07 by deeDawnteeI would never assume that all antibiotics are compatible with K+, (or any other med) because you just never know when a new one may not be.
If your book or chart does not list the MIV, you can just check your antibiotic against potassium besides the D5 .45% NS fluid.
There are websites that provide this information. At my hospital, we use Micromedex. One can quickly ensure compatibility for all the IV meds a patient is on with this program. I would bet that you have access to something similar where you work that your hospital "subscribes" to, I would ask about it.
I like that you are being careful. Great job!
- 0Oct 30, '07 by bill4745Also, please remember that IV chemical compatibility and drug interactions are two very different things. This sounds simple but I've known experienced nurses who looked in a drug book for interactions between drugs, found none, and piggybacked them, only to have the tubing fill with precipitate.
- 0Oct 30, '07 by meownsmileLook up KCL in your IV drug book. The entry for potassium should list any compatability issues. Dont try to find the IV fluid with potassium it isnt there. You have to look drug by drug. Or call your pharmacist in the facility if you have problems. That is what they are for and they have quick computer access to those issues.
- 0Oct 30, '07 by firstyearstudentOur 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