Help. Starting IV Piggy Backs without Primary Order

  1. Ive heard different things from different people. so Please help:

    I am used to patients having Normal saline already infusing continuously so when an order for an antibiotic piggy back comes in, I just add it as secondary because it doesn't matter that the NS was already infusing. BUT...

    What if a pt. does not have have an order for a Primary infusion but you DO have an order for an Antibiotic piggy back. Do you still prime the primary line with NS first? Or do you let the antibiotic prime all the way down to the primary line (while hanging the antibiotic as a secondary)?

    I hope that wasn't too confusing and its so hard to ask around because some people don't understand what I'm asking.

    Thanks
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    About RnStarvingstudent88

    Joined: May '17; Posts: 8; Likes: 3

    12 Comments

  3. by   OcMurse93
    There would be no need to prime the tubing with NS as long as the order doesn't call for it. I have seen Piggybacks running on their own all the time. TECHNICALLY its called a piggyback for a reason and should be infusing with a primary line, but if fluids are contraindicated (e.g. renal failure) then you might see this. Just double check that they don't have/need to have a primary line running beforehand and it is programmed at the proper rate.
  4. by   RnStarvingstudent88
    Why is magnesium ran with lactated ringers?

    Also, I know that Mg is ran through one channel and the LR is ran through another channel. But where do they connect because I was told and I read that " Piggyback MgSo4 solution to lowest port of control IV line." What does this mean? I thought that Mg runs in one arm and that LR runs through another arm so that they never mix.
  5. by   Triddin
    If you hang the medication through a primary line, don't forget to flush the line afterwards with a bit of fluid so the patient gets all the medication
  6. by   RnStarvingstudent88
    I was told that LR and Magnesium are run into their own separate channels. But I was also told that it it supposed to connect at the lowest control port. What does this mean?

    Im having a hard time imagining how this would all connect because a Piggyback tubing would not have that blue stretchy part that clips into the Alaris to set the rate. Unless i use two primary tubings but how would those two connect at the lowest control port?
  7. by   RnStarvingstudent88
    Can either of you explain how to piggyback Magnesium while using two channels? For example: Lactated Ringers in Channel A and Mag in Channel B. I know they are suppose to connect but i cant figure out how. Thanks for responding.
  8. by   Triddin
    Goodness. Usually one post is sufficient, you don't need to make multiple. 5 is rather overkill. As long as mag is compatible with RL, you can either connect it through the top y site as a secondary, or connect a primary line to the lower y site on the access line and run your mag infusion through a separate channel
  9. by   RnStarvingstudent88
    Sorry, I didn't realize that, I wasn't seeing it pop up so I was wondering if my post was going through due to my slow connection.

    But thanks for answering. Can you clarify if we are able to connect the two primary tubings together at the lower y-port closest to the patient. ( I have a skills test for class).
  10. by   Triddin
    As long as what ever you are connecting are compatible and you remember to check compatibility with any secondary medications you hang
  11. by   Ladyscrubs
    Hi Starving,

    Okay I get what you are asking:

    The two are compatible, even though Mag is usually mixed in NS or D5W. Program both your channels as primary and put LR and Mag on primary tubing, connect the Mag line to the port of the LR under the pump,... I would connect to the lowest/closest port to the patient. Label your tubing, above and below the pump to make your line easy to trace.
  12. by   Rose_Queen
    Part of being a nurse or even a nursing student is knowing where to find your resources. What resources might guide you on how to run antibiotics with or without a primary fluid line? Policies are frequently developed to answer just those questions. As for setting up the pump, that is a question best answered by someone who knows the pump used in the facility where your clinicals are taking place- your instructor.
  13. by   RnStarvingstudent88
    Thank you so much Ladyscrubs. Yes that was exactly what I was asking. I wasn't sure if it was possible to connect two primary lines that way. It was just verbalized but never demonstrated. I had been researching with no success.
  14. by   Have Nurse
    Some times you can just use a saline lock, flush it, and hang the antibiotic. Flush again with saline afterward. But if you aren't sure, clarify it.

    Your message was not specific as far as whether or not there is a primary running. If there is, you should prime your piggy back tubing with the antibiotic before attaching it to the main tubing, to prevent air embolism.

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