Question about priming tubing - page 2

Hey everyone, When you hang an ABX through a primary line how to prevent the line from going completely dry so that you can hang the same ABX a little later? It seems like most people use the... Read More

  1. by   retiredmednurse
    Quote from akulahawkRN
    It depends upon how I'm going to run the medication. If I'm just using the IV intermittently, I'll just prime a primary line and not worry about running the drip chamber dry. If I have a maintenance running, I'll hang a secondary line, placed above the primary bag, and program a "secondary" med into the pump. This way the med runs until it's gone and the primary bag takes back over and flushes the line. With that setup, very little medication is left in the tubing, and if I want it ALL I can just backprime the secondary set, spike a new small bag of NS (or whatever maintenance fluid) and hang that as a secondary for a few mL to push all the med firmly into the primary tubing and into the patient. Then I'm left with a primed NS secondary set... That being said, that's a lot of work for what's usually just a couple mL of a medication from a bag that's usually slightly overfilled to compensate for whatever is left in the dripset when the infusion is done. Most of the Abx I run will "finish" with the bag still having a little left in it and the tubing still primed. It's rare for me to have a dripset run dry to the pump before the infusion "completes".
    I TOTALLY agree with him. I preferred running my IVPB as a secondary and let the flush bag or maintenance bag take over. At my hospital not all meds had to be on a pump. Using a primary line saved many times a line going dry on my if I didn't catch it in time. Very frustrating if I have to restart my saline lock when I'm busy enough as it is.
  2. by   MunoRN
    Quote from iluvivt
    Yes you can run an antibiotic or any IV med on a locked VAD .This is a perfectly acceptable practice and we do it all the time when no IV fluids are ordered. Is it easier to hang a flush bag and run it as a secondary...some may think so.What if your patient just has an antibiotic.once a day? I think it's so much easier to administer as a primary intermittent....that is the correct terminology.All you need to do is not let the drip chamber go dry and then there is no air to worry about and just spike and prime out the minimal amount left over.
    Using the antibiotic to prime the tubing will typically waste at least some amount of the antibiotic, we measured the actual amount used among our nursing staff, and wasting 20ml while priming wasn't unusual, with a 50ml bag of antibiotic that means almost half the dose is going in the sink rather than the patient. If you're using a saline or other bag to flush the in the end then at least you're not losing what's in the line, but at that point why not just add the secondary set (which my facility pays $0.81 for) and not lose the priming waste either.

    Quote from iluvivt
    Primary intermittent tubing,according to INS should be changed every 24 hours anyway so if you do have a q 24 hr dose you can get a new tubing.If you have the desire to know why this is the INS standard I will be happy to explain.
    I haven't been able to get the INS to explain their rationale, so if you can explain it I'd be happy to hear it.
  3. by   Cat365
    Check your hospitals policy. We have to run antibiotics on a secondary line. The primary has to be used to prime and flush the line to avoid the patient not getting the full dose per policy. We can actually order normal saline " for line care per policy if there are no orders for a primary. Of course I work ER and our charting/rules, and policies are a bit different than inpatient. I think that's hospital wide though. I would suggest checking your unit/hospital policies.

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