Morphine PCA and Heparin drip, compatible?

  1. Hi. Searching my micromedix at work, I did see that morphine sulfate and Heparin are compatible. An IV nurse even told me that the tubing could be connected to a y-site. Browsing my 2005 Lippincott's Nursing drug Guide, it reads that heparin and morphine are not compatible. I sometimes see patients who are hard sticks and have one or two PIV sites and Morphine PCA, IV abx, fluids, heparin gtts running. Any input?
    •  
  2. 9 Comments

  3. by   gitterbug
    Where I come from a PCA is never hooked up with anything else. Heparin either. If they are that bad a stick then a central line is used.
  4. by   Lacie
    I've always been taught that nothing else is to be pb into a PCA nor to a Heparin drip. If the person is that difficult then they need a central or a pic line.
  5. by   augigi
    I believe the solutions are compatible, however you would not want a patient to get a heparin bolus via the PCA line.

    heparin
  6. by   TallGirlAni
    Quote from Lacie
    I've always been taught that nothing else is to be pb into a PCA nor to a Heparin drip. If the person is that difficult then they need a central or a pic line.
    PICC lines are done on tuesdays and thursdays, and central venous lines are placed by MDs. On the med surge floor I work on, (the PM shift), it is almost always difficult to get any central placed in an instant. Therefore, I must work with what I have. So, my question is, does anyone know for a fact if these solutions are compatible, since I have two differing sources? If they are, then I would most certainly connect them to a Y-site. Does anyone know for certain if these are compatible, or if I could be pointed to a reliable source to ascertain if they are or are not for future scenarios. By the way, I would be using a double chamber IV pump, with one chamber for the heparin at the given rate, and the other chamber for the morphine PCA and primary fluid bag.
    Last edit by TallGirlAni on Dec 6, '06
  7. by   CV_RN
    All of our morphine PCA pumps must be infused via d5 1/2ns at 45 cc/hr per pre made PCA orders. our PCA tubing has a valve that prevents the IV fluids from backing up into the pca tubing and infusing as a bolus. I would NEVER mix a PCA pump with anything other than standard iv fluids. that's too much liability! if you can't get another access then the DR needs to change one of the drugs to PO until access can be obtained!
  8. by   CarVsTree
    I agree with the other posters. You should not have a PCA going into a Hep gtt line. The PCA boluses would effect the rate of the heparin.

    We have tons of PCA's and a lot of Heparin gtts on my floor, I've never seen the two together.

    PICC, line, or additional periph. or IV morphine. Disconnecting and reconnecting the heparin gtt. Can't think of any other way.
  9. by   TallGirlAni
    I am not talking about running the PCA with the heparin on the same pump and same tubing. I am saying that one pump would run the heparin with the tubing to a y-site that would be connected to the PCA tubing and fluid (D.5 .45 or NS or LR or D.5 .45 w/ 20K) tubing on another pump.

    The fluids in the tubing would meet at the Y-site and then be infused via the PIV.
  10. by   Mulan
    Ask your hospital pharmacist.
  11. by   bluesky
    Quote from mulan
    ask your hospital pharmacist.

    i was just thinking this!

    i guess in a real super pinch i might y connect them, as long as the y connector is right by the hub of the iv, so that a bolus in one doesn't affect the other.
    Last edit by bluesky on Dec 6, '06

close