I am a student (very soon to become RN!). I have a question regarding intermittent infusion. In our skills lab we use gravity poles and are taught that the safest practice nowadays is to hang mini-bags aka intermittant infusions with a primary bag of NS. I get the reasoning behind this, no problem. So if your client has a saline lock and you are already going to be attaching a primed line to it, could you not use the primry line to check for patency and flush(along with other methods such as site assessmnt etc..)? Would it not be the same as a saline flush only your using your line which you have right there instead of syringe? any thought? thanks.
Oct 2, '12
First of all many places DO NOT hang a medication line. I see this in the ICUs a lot but not elsewhere. Let me get the terminology straight for you. If you have a primary line with D5 and 1/2 NS infusing with 20 meq KLC at 125 cc per hour and you have a compatible antibiotic you could hang that abx as a secondaty or piggback it into the IV. . This entails hanging the abx above the pump and into the first injection site. You will not see much run as a gravity infusions anymore due to the safety culture these days. You may see gravity set up as in dial a flow tubing in clinics and in home infusion and ambulatory infusion centers .
Now if you have ANY locked VAD (venous access device) such a saline loc or PICC and you have an intermittent infusion..that would be called a primary intermittent infusion. If you have any locked VAD and you are getting ready to infuse something you should verify the patency of that line with an appropriate flush of NS, and in rare case it may be D5W if the drug is only compatible with that and not NS).. Yes flush,verify patency and infuse the medication.
Now if you have a medication bag or a large volume parenteral infusion going and you are going to piggyback an infusion into that you do not need to verify patency if you have an infusion going without any problems such as frequent occlusion alarm or something of that nature. . If you have a dual lumen VAD,say a dual lumen PICC and you are going to use the locked lumen than yes you would am not sure exactly what you mean by verify
How is it that you can use a primary line to verify patency? Do you mean by creating a pressure difference? You need to check patency with a fluid filled syringe of NS. You need to feel how easy or not it is to instill the flush as well as that will give you a valuable piece of information. If it flushed with resistance how are you going to check that with a primary bag of IVF.
I am certain the rational for using a primary med bag of IVF is to limit the amount of access into the VAD thus potentially decreasing infection risk. I does however have drawbacks as well as it is not always the best way to decrease infection risk. I hope that answers it for you b/c I am not sure what you mean by using the bag for a flush.
Last edit by iluvivt on Oct 2, '12