Different Piggyback Antibiotics, Same IV Tubing??

  1. 2
    Hey all,
    I just had a quick question about something I was taught in nursing school and was wondering if you learned the same thing, or practice this yourself.

    You have 2 different IV piggyback antibiotics (compatible or incompatible, doesn't matter) with NSS as the primary, and one is due at 1200 and the other is due at 1800. You hang the one due at 1200 then leave everything hooked up until you come back again at 1800 when the other antibiotic is due. Instead of getting all new secondary tubing for the new antibiotic, we learned to just back prime the NSS into the piggyback line a few times to flush what's left of the 1200 antibiotic into the old antibiotic bag, then disconnect and reconnect the new antibiotic. I was told that you don't have to worry about the 2 antibiotics mixing because you back primed with NSS and all that's left is saline in the now reprimed piggyback tube.

    Does anyone do this to save time and cost to the patient? Just wondering...thanks!

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  2. 61 Comments...

  3. 2
    Hmm I've never heard of this. And in my school they always taught to use new tubing for each antibiotic or whatever it is. And throughout all my clinicals I've never seen nurses do that either
    seanynjboy and poppycat like this.
  4. 1
    I have never heard of this at my current hospital, but did see a nurse do it once at a LTC. Doesn't seem right though, I would just use a new tubing.

    Sent from my iPhone using allnurses.com
    poppycat likes this.
  5. 5
    I back primed IVPB all the time when working in the ICU. It saved a lot of time and cost. I did leave something on a dedicated IVPB tubing like dilantin. Other than that it was backprimed. Otherwise you had a ton of IVPB tubing hanging around. I was taught this in nursing school as well.
    KayRN1, wooh, JenRN30, and 2 others like this.
  6. 2
    I too, was taught this in nursing school. Our clinical instructor had been teaching other methods up until my class. Per the instructor, something caused her to look into it and it was considered a safe practice with the Infusion Nurse's Society.
    applewhitern and Esme12 like this.
  7. 8

    Yes an acceptable practice..... see above article! backpriming prevents constant breaks into the system.

    Read the following discussion: Lynn Hadaway Associates, Inc.: Studies on Backpriming
    Stcroix, flyingchange, nrsang97, and 5 others like this.
  8. 1
    I was never taught this in nursing school, nor ever encouraged to do so over my 35+ years. I would discuss this with your charge nurse or unit manager. I would encourage you to look at EBP studies to see if this is even an appropriate method of practice before doing.
    Serlait likes this.
  9. 3
    I do that sometimes... Especially if my floor is out of piggyback tubing. It is better than a lot of times when I find piggyback tubing without a cap on the end (red caps aren't readily available where I work). I'd rather back prime the connected tubing than use the probably contaminated tubing

    ~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~
  10. 0
    I guess I don't so much see it as an issue. We talked about it for like 5 minutes in lab one day during nursing school (but like everything in school you had to follow policy for your clinical location...) It makes sense though. Where I worked as a med-surg nurse our policy (and it was in the policy) to use one set of piggyback tubing for each item run as a piggyback. Ex. your zosyn would have a set of tubing, vanc would have another, keppra would have another and the tubing could be used for three days if it was kept capped between uses. I think I would still be very cautious with things that are incompatible...
  11. 7
    Backprining is common and is acceptable.

    Secondary infusions: Backpriming technique - CareFusion

    alibee, emerjensee, KayRN1, and 4 others like this.

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