With our system, we have two ways of doing it with our tubing:
1) The medication is <0.5ml and given over 15-30 minutes
The medline is approx .5ml (0.4ml + tubing to the IV is 0.1ml). So we push the med through and apply a 0.5ml flush onto the med-line. The 0.5ml flush is then placed on the smart pump over 15-30 minutes. We just do volume over time since 'normal saline flush' is not an option, so it is entered in as .5ml over 30 minutes.
2) The medication is >0.5ml and given 15-30 minutes
The medline is approx .5ml (0.4ml + tubing to the IV is 0.1ml). Since the medication is > the distance of med-line and tubing, we have to use another microbore. We attach medication + 2nd microbore and push it through till med hits the tip. Then we attach med + 2nd microbore filled with med to the medline and push the med (usually will be about .2ml left in syringe) so that the medline + 2nd microbore are filled with med and flush. And then attach a 1ml flush to 2nd microbore and put the flush on the syringe pump over 15-30 minutes.
3) Medication such as Vanco (in a 5cc syringe) drawn up at for example 2.2ml. We put that med on the pump (attached to the med-line) and run 2.2ml over 1 hr, and then attach a flush (0.5ml) in the same syringe size (5ml syringe size) on the pump and run it at the same rate (2.2ml in 1 hr) so the flush runs in at the same rate as the med. It is important that when you do it this way you use the same syringe size as the medication drawn up, since the smart pumps read the syringe sizes.
This was so confusing to our nurses when we started this in March, but we have guidelines next to every bed-spot reminding us of the proper way to do this. What a headache at first but it made sense after a few times of doing it.
Hope this gives you an idea what my unit does