Yesterday I had a patient who was on 3 IV antibiotics: zosyn, zyvox, and levaquin. We use micromedex to check compatibility so I found through there that zosyn and zyvox were compatible, so there was no need to change the tubing. I was using normal saline for the primary line to piggyback the antibiotics into. I programmed the normal saline to run for a volume of 10 ml at 10 ml/hr once the piggybacks finished. The levaquin was the third one that I hung, after the normal saline had run through, and I disconnected the previous secondary tubing and hung the levaquin piggyback with the new tubing after the flush had run (with the old piggyback tubing from the zosyn still attached, if that makes sense?). If I remember correctly, the zosyn was the one that was hung before the levaquin, and zosyn and levaquin are not compatible. (So the order was zyvox, NS primary, zosyn, NS primary, levaquin, NS primary). I was wondering if the 10 ml primary was enough to clear the tubing of the medication? Thank you and please let me know your thoughts, I truly appreciate it.
Feb 20, '12
It is difficult to answer the question without knowing what tubing you are using. Some IV tubings hold 27mls from drip chamber to tip, others only 16mls. Are you hooking to the upper "Y", and what volume then is from the Y, or side port, to the tip... However, if I am running saline in, it will usually flush at least 1/3rd the tubing (upper half anyways) and then the Levaquin starts, so I really don't see that as an issue.
Feb 25, '12
thank you, IVRUS. I appreciate your response!