TPN, Chemo and double lumen central line

Nurses Medications

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Work in an ambulatory surgical center. Had a patient come in with TPN and Chemo infusing to his double lumen central line. Patient having a procedure done under IV sedation. Anesthesia had TPN infusion stopped, flushed line with 10cc NS and then started infusing Lactated Ringers. Anesthesia did this so that line could be used for sedation meds (fentanyl and versed). Patient had procedure (Celiac Plexus block) which lasted about 5 mins - LR continued infusing until finished (about 20 mins) and then TPN restarted. Was it okay to dc the TPN and use the line for meds and then restart the TPN. Pat has chemo and TPN infusing running continuously on outpatient basis.

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Specializes in Infusion Nursing, Home Health Infusion.

YES absolutely fine!!! I would have done the same with all the variables. Better to leave the chemo line alone and use the TPN lumen for that amount of time. What was the concentration of Glucose as abrupt cessation of the glucose can cause a drop in blood sugar...20 min is not too bad though...just check it...or the could have added some D5W in there...they really like those balanced electrolyte solution in OR. Best to leave the TPN as dedicated lumen..that is what you probably were thinking.and you basically are its just that you had to look at the benefit vs the risk...and clearly the benefit to the patient outweighs the risk especially if no one could obtain vascular access for the procedure. I am assuming that is what happened or they looked and thought it might be difficult. My first choice would have been to place a PIV but we all know that is sometimes easier said than done

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Specializes in CVICU, CCU, Heart Transplant.

as the other poster said, I would have placed a PIV to run your other meds rather than stopping the TPN.

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Specializes in Med-Surg.

Hi,

I am an RN with chemo and TPN experience. It was fine for the TPN to be stopped to infuse the sedating meds. It was a brief interruption, and it was started right back up. It was better to use the TPN than to stop the chemo, as most chemo has to be started at the same time everyday (for 24 hour bags).

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