Main IV line

[4ab]

At my current unit, it is a practiced to have a main line of NS then we piggyback a secondary line which could be anything like cardizem, heparin, natrecor, dopa, dobutamine and everything else. To me it is a lot of fluid to a patient in a cardiac unit and a big waste of money. The old staff say's it will clog the line but i say no way since it's a peripheral line and not a central line like picc or tlc. i would like to know what practice are you doing in your hospitals.

thanks

[saskrn]

Do we need to obtain a physician's order to hang the NS at TKO? Thanks!

You need an order for any IV, unless there is a policy/protocol in place to cover you.

[Dixielee, BSN, RN]

It depends on where you work about a specific order. I work in ER and almost everyone gets an IV. It is standard protocol for certain complaints. When I worked ICU, it was standard practice to have a maintence line running with drips. It does vary for place to place though.

[NurseFirst]

BY LAW (at least in the U.S.), starting an IV generally requires an MD order (not sure about NPs and PAs, and laws vary from state to state for them). Places where RNs "start an IV without a doctor's order" is not quite true; they start an IV with "standing orders" and "protocols". These are what make it possible for an RN to run a code in some places, and make it possible for paramedics to do whatever they do in the field without having to call the doc for everything--because there are standing orders.

NurseFirst

It depends on where you work about a specific order. I work in ER and almost everyone gets an IV. It is standard protocol for certain complaints. When I worked ICU, it was standard practice to have a maintence line running with drips. It does vary for place to place though.

[zacarias, ASN, RN]

The hospital I worked at before always had a main NS TKO line where vanco, electrolytes would be piggy backed in. You always were safe to have a patent line that way.

Now where I work they don't usually do that. They just hang whatever they hang and then piggy back. I see benefits to both ways as far as cost and time but the NS TKO is probably most "clinically" beneficial.