IV questions

[schrutefarms]

Hello, all. I'm currently a nursing student and feel silly for not knowing a lot about IVs. I've noticed that some pt's will have two or more drugs running into the same IV access point. Let me ask my questions via an example. Say you have a pt who has NS running at 100 cc/hr in the left antecubital. You get a new order for an antibiotic. What determines whether or not you need to start a new IV site? I imagine it has something to do with what drug is ordered...does it also have to do with how fast the infusion is going to be? I just get confused. It doesn't seem logical to run NS and antibiotics at the same rate when they're serving completely different purposes..but I've seen them run together plenty of times. Thank you SO much for taking the time to answer, if you do! :)

[NICU Guy, BSN, RN]

The compatibility of the two fluids is what determines if they can be run together.

You can have NS running at 100 mL/hr and another medicine running at 20 mL/hr through the same IV. The NS will not cause the other med to run at a faster rate. IVs are run at amount/hr, not distance/hr. For example, you have two roads merging into a bridge. On one road, a stop light allows only 100 red cars/hr to cross the bridge. On the other road, the stop light only allows 20 blue cars/hr to cross the bridge. Does the amount of red cars on the bridge effect the number of blue cars on the bridge? No, the stop lights control the rate at which the cars are released, the same as an IV pump controls the rate of the fluids released into the tubing.

[schrutefarms]

I didn't explain that correctly, sorry. I mean like two running on the same line from the same infusion pump.

[jvanwoman]

The antibiotic will be running as a secondary at its own rate through the same pump. I recommend playing around with a pump and getting acquainted with the features. You will understand it better.

[Cvepo]

As the drugs are infused, the pump will inject them at the appropriate rates. They get combined in the tubing (hence why compatibility is important), but since the secondary medication is going slower, it may get to the patient "faster" by mixing with the faster running saline, but the medication itself (ex: 1g of cefepime over 15 minutes) will still take 15 minutes to completely empty the bag. If you were concerned with the pump improperly infusing, you can always run the second med on a separate pump and utilize either a stopclock or y-site connection. But antibiotics usually are not the infusions to be super concerned about.

You need other access when meds are not compatible. Nearly everything is compatible with NS. If it was D5 0.45% NS, then you might need another line... if they aren't compatible.