What do you do when....?

Nurses General Nursing

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If you have an IVPB antibiotic to hang for a pt who is hep locked, do you run the IVPB using primary tubing and run it as a primary line and set the rate less than the amount of the IVPB, example 50cc/hr, set rate at 45 so your line won't run dry.....then flush w/NS after....

or do you?

Set up a primary line(NS 1000ml), & Piggy Back the antibiotic onto it.....

if you do this what would you set the rate & VTBI of the NS at if you only wanted 20-50cc of NS to go in to flush the line after the PB?

thanks for any input

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We always set up with a primary line, just to run at TKO after the Piggyback is done.

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Specializes in CCU (Coronary Care); Clinical Research.

I usually run the piggyback on it's own and then flush the line--unless I have a tko line already hooked up. If I have the line hep-locked, I don't see any reason to use 1000cc NS bag--if for some reason I think that I need a carrier fluid for the antibiotic, I will use a 250 ccNS and stick the ABX in a y-port of the tubing (both on seperate pumps so I can pick the rates). I love pumps!

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We always set up with a primary line, just to run at TKO after the Piggyback is done.

Thanks for the response.....

At your hospital what is TKO, is it 40-50cc/hr? and how long can you run this for w/o and order? Would you just disconnect after about and hr and go back to the hep loc if no other IV tx are scheduled?

thanks again

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I usually run the piggyback on it's own and then flush the line--unless I have a tko line already hooked up. If I have the line hep-locked, I don't see any reason to use 1000cc NS bag--if for some reason I think that I need a carrier fluid for the antibiotic, I will use a 250 ccNS and stick the ABX in a y-port of the tubing (both on seperate pumps so I can pick the rates). I love pumps!

THanks for the response.....one more question??

If you were running the IVPB on its own and were just going to flush the line after it was done, would you set the IVPB VTBI at a lesser rate so it won't run dry..like 45cc VTBI for a 50cc bag?

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Specializes in CCU (Coronary Care); Clinical Research.

I put all of my ABX on a pump--even if I overset the amount to be infused, the pump beeps--shows "air in line" at the pump site (of which there is at least a foot of tubing after) and will not continue, therefore not allowing any air to the patient, but "wasting" only close to 1-2 cc fluid. I figure, if I have pumps available, I may as well use them. I almost never gravity IVF...guess that is the way that I was trained.

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I put all of my ABX on a pump--even if I overset the amount to be infused, the pump beeps--shows "air in line" at the pump site (of which there is at least a foot of tubing after) and will not continue, therefore not allowing any air to the patient, but "wasting" only close to 1-2 cc fluid. I figure, if I have pumps available, I may as well use them. I almost never gravity IVF...guess that is the way that I was trained.

Thanks for your help!

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Thanks for the response.....

At your hospital what is TKO, is it 40-50cc/hr? and how long can you run this for w/o and order? Would you just disconnect after about and hr and go back to the hep loc if no other IV tx are scheduled?

thanks again

Yeah, we usually run TKO at 50... The orders are usually written to state something like, Pt may be heplocked in between antibiotics or something to that effect. And our pumps are set, to let us know when the antibiotic is done, so the patient gets very little of the primary...

We unhook the tubing, cap it.. and then hook it back up whenever the next dose of antibiotics are due.

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In LTC we need orders for everything.. most of our res are just getting the ABX and no fluids, so I just set it up as a primary and set if to infuse less that the amt in bag say 45 out of 50 ccs.. after it beeps if some left I try to get it infused then flush line per SASH.

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Specializes in Neuro Critical Care.

If it is a once a day dose I will run it on a primary line. If the abx is to be hung q6 or q8 then I will piggyback it into a 250cc bag of NS. Yes I have kept KVO going without an order...if a pt has a 22g or 24g that was difficult to obtain I like to keep some fluid runing through the port. Our KVO is 30-50cc/hr.

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Research into the cost of different sizes of Normal Saline bags at our hospital has shown that the smaller bags cost the hospital more $ than the larger bags, and the 1000ml bagswhere I work are only like 56 cents each, where the 100ml bags are 65 cents each. We're encouraged to use a 1000ml bag for uses such as carriers, cardiac outputs, pressure bags, etc.... :)

Just a little FYI. :)

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