Can you piggyback critical meds like IV Potassium or Mag at your hospital? - page 4

by Angie O'Plasty, RN

I was taught that we cannot piggyback potentially dangerous IV meds like KCl and Magnesium. Instead, we hook up the KCL to a primary line that goes directly to the pump and then to the patient. That line is labelled. ... Read More


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    I think that one thing should be made clear (this took me a while to figure out too). When you piggyback or run something as the secondary, your primary fluid is suspended. That primary infusion stops and whatever is in the rider/secondary/piggyback is the only thing going through the line. I think that some folks feel that the primary is further diluting the piggy back/secondary but it is not. It is there so that the line does not run dry when the piggyback is finished.

    I have found that the technique described where K spiked as a primary with its own pump and NS is run through an additional pump, then attached below the pumps causes the least discomfort to the pt.
    ohiostudent'RN likes this.
  2. 0
    Ours hang with separate pumps, with both having primary lines. mg hooked after the primary line pump (NS pump), when putting in volume of MG rider compensate for line amount. running med over 4 hours.
    understand concept of missed med.
    Other hospitals i have been running it as a piggy back connecting bag to primary bag (NS) connecting prior to pump. (lowering primary bag).
    If set right, the right amount is going in,( I think i remember a rate of 25 or 27ml hour)
    100ml bag.
    anyway the I have seen two problems with this, one must remember a piggy back runs alone, which means the primary stops dripping with the piggy, unless bags are set equal. so one must remember to not bolus when air in the line, because its the piggy thats going, second, if you haven't set the volume right your piggy stops and the NS continues, your pt does get the mg, till you notice, because an alarm will not go off.
    But in the end of both argument, I think as long as the rate is low either way is safe, if mixed with the NS should be sufficient.
  3. 0
    Our IV pumps have the ability to run concurrently. So primary fluid + potassium (at Y-site) run concurrently over 2 hours or more. No need for an extra pump if your pumps have a "concurrent infusion" option.
  4. 0
    Yes, I piggyback K and Mg. And by piggyback, I mean as a secondary. In which case, the "big bag" of NSS is not running and not diluting the K (our K comes in premixed bags of 10 meq/100 mL NSS). As for Mag, I piggyback that as well--recommended at 1 gram/hr, although one doctor had me run 2 grams over 30 minutes for an asthma attack.


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