When you have to run several medications through a chest port and there isn't any info on compatibilities. Whole Blood, nexium, D51/2NS, morphine. Pharmacy can't help. Veins are very poor. What is the answer?
Jan 30, '09
I am assuming you have a single lumen port here,there are dual lumens as well. OK here is what you nned to do. First blood cannot be administered with any other drug..only NS to prime the tubing with the blood tubing and post infusion and add it to the bag if necessary. So no do not administer blood with anything else. So if the patient can hanle it you have to shut everyting else off. You need to determine at that point what need to be given in a PIV if nothing can be shut off...so choose the most least irritating thing. I would choose to give the blood peripherally in most situations becasue K+ in large volume parenteral,antibiotics and other medications can be quite irritating. heparin..you will find is easy on the veins. if you have medications that are compatible if they are not mixed for prolonged periods you can set it up with a t-extension or a dual or triple add on device right at the huber needle tubing. Some of these non-coring needles already have a y-site pre attached and some already have a neeldless device pre attached...some do not and you have to remove a small needle cap and attach a needleless cap. the you hook your primary line in and you can piggyback compatable meds into that. you then can set up a second drip at the site only at these add on extension or the y0site of the non-coring needle. the priming volume of most ports is approx 2.5 ml on average so you can see there is minimal mixing. the only time you may have problems with a physical incompatability is you are administering medications with extreme ph differences at the same time such as something very basic and something very acidic. it gets tricky i know. A good IV nurse if available can help you with a set-up. I do this all the time fo my fellow RNs and they sure do appreciate it b/c it can be a pain.