Giving iv meds through running line

  1. 0
    New grad RN here, just curious about giving iv meds (antibiotics, phenergen, etc) through the iv line that is already running. I know it probably seems basic but it confuses me. Do I still need to dilute the med, or does the fluid running dilute it? Certain meds need to be pushed over 2 mins- how does this translate with an IV pump? Do I give it in the furthest port from the patient (I've tried to give it above the pump, found out quickly that doesn't work!)? I have just been pausing the iv fluids, unhooking the iv, and then pushing the diluted med the old fashioned way...wondering if there is a quicker way?? Thanks for your help and patience

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  2. 20 Comments...

  3. 0
    I don't dilute if there is a running iv
  4. 3
    If the fluid is compatible with the drug I always just let it keep running (often turning up the rate if it's on gravity tubing to provide further dilution). When I am done pushing the drug I draw in some fluid from the bag to use to flush it. I definitely advise not unhooking the tubing. It wastes time and every time you do it you risk contamination.

    If the fluid and drug aren't compatible pause the fluid, flush, give the drug, and flush before resuming the fluid.
  5. 1
    Quote from Perpetual Student
    If the fluid is compatible with the drug I always just let it keep running (often turning up the rate if it's on gravity tubing to provide further dilution). When I am done pushing the drug I draw in some fluid from the bag to use to flush it. I definitely advise not unhooking the tubing. It wastes time and every time you do it you risk contamination.

    If the fluid and drug aren't compatible pause the fluid, flush, give the drug, and flush before resuming the fluid.
    This. I would only add that if you're using a pump, consider it the same as if it were gravity fed. I would also do the IV Push at the port closest to the patient so that there's minimal drug in the line that still has to be flushed/pumped through the line after I'm done with pushing the med in. I would only unhook the tubing as a last resort because of potential contamination issues.
    DachRN likes this.
  6. 0
    Moved to Nursing and Patient Medications for more response.
  7. 0
    I'd still dilute phenergan and add it to the port farthest from the patient. I actually dilute everything as I usually would when I have fluids going. Remember to pay attention to rates though. If fluids are set at kvo and you put it in the port furthest from the pt, it will take a long time to get to them and go in.
  8. 0
    I put it in the port below the filter. I always dilute meds (phenergan, narcotics etc) running fluid or not. Just make sure what you are giving is compatible with the fluid you are running. I would not disconnect the line to give the med. This would add to the risk for contamination.

    Our antibiotics are in piggyback bags and are added to the port above the pump and programmed into the pump for administration. Actually, I believe that is the way it is now recommended that phenergan be given (in 50cc ns over 10-15 min). We now give more zofran than phenergan.
  9. 1
    When I get busy I like to use the secondary line and hook my syringe up to it and set it to run 2-5 min. Dilute based on your hospital policy or judgement call.
    turnforthenurseRN likes this.
  10. 1
    I always dilute phenergan in a 50ml bag of Ns at 15min. This is to help save the possiable risk of hurting the patient and to save the site. I always dilute my narcotics cuz once it's in it's in and I have had to stop the push due to patients reactions twice. Of course at this point call the Dr. to let then know. I always give at the port closest to the patient. This is where Pca's should be hooked up also so the patient gets the maximum pain control. Then I clamp the line and then flush afterwards with 5-10 cc with the line still clamped. This was the policy at my hospital. I even had JAHCO watch me do this once with Morphine. The asked step by step questions and then stated that I was completely correct. I hope this helps. Also please give meds slow IV push. I have had patients tell me that they felt that this was better that say someone else that just pushed fast.
    turnforthenurseRN likes this.
  11. 0
    Moorefun, when you say you clamp the line, where are you clamping it at? I'm sure it would make perfect sense if I was watching you do it. So you have fluids running..you draw up your morphine (diluting it first), push it into the port closest to the patient, clamp the line, then push NS in the same port?


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