Pitocin as a secondary on a pump?

Specialties Ob/Gyn

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Hello all,

We are in the process of revising out pitocin policy for induction/augmentation. We have recently been told that when we set up our IV's we need to have a mainline that will be used for boluses (not on a pump), our normal IV fluid (at 125) is to run on a pump. The question is: Can pitocin be hooked up as a secondary on the pump? the mainline (no pump) would be what would be used for fluid boluses etc. My manager says that this is the way that this is the way that she wants it done (pitocin as a secondary on the pump). Thoughts?? Does anyone else do this? Thank you!!!

Their argument is that you are still hooking the pit to the closest port to insertion, because it is going in through the pump tubing. If you need to shut the pit off, you need to shut the whole pump off. I don't agree either...........like I said, I want to use two pumps. they say no. That's why I was wondering if I could find anywhere else that does it this way?? I had always thought that pit was supposed to be on a line all of its own.

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Specializes in PERI OPERATIVE.

Just curious: if you have your pit piggybacked on the pump with your main IV, and your main IV is at 125ml per hour, how do you control the pit?

Oh and TKO = To Keep Open.

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Ah. thank you. we use KVO-keep vein open.

The secondary line has its own program to set. The manufacturer says that you can run two things (even sensitive medications) at the same time at different rates, and they will, in fact, run at their independent rates. The secondary line still only allows a certin amount of pitocin into the line

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Specializes in PERI OPERATIVE.

Do you have double pumps?

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No. all we have are triple pumps. they are ENORMOUS. Apprently the company doesn't make double pumps, which I find odd....would be a win all the way around

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Specializes in PERI OPERATIVE.

Triple pumps?! I didn't know they made such an animal!

But I still say that you need to have your pit on the port closest to the vein.

Tell your boss to check out the ACOG and AWHONN standards.

(PS- we run everything on piddley old single pumps. We are lucky if we get a double one!) :bugeyes:

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some of the other staff agree with her, which stinks. Thank you so much for your input. I'll keep doing some research and checking back here to see if anyone else does their pitocin this way (I find it very bizarre).

Thanks for your comments. Off to bed, have to work tonight. :) Take care

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Specializes in Maternal - Child Health.

If your manager insists on being cost-conscious about pumps and tubing, why not just run the primary IV in by gravity, and reserve the use of the pump for the pitocin, which would be connected to the port closest to the patient?

I would rather run the maintenance IVF by gravity, perhaps using a buretrol to control the amount of fluid that would be available in the event of an inadvertent free-flow, than to have 2 different bags of IVF, one on a pump and one not.

jJWjould that be acceptable by AWHONN standards?

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I agree with the last poster. Start your main line fluid with blood/anesthesia tubing and run by gravity at whatever rate is appropriate - the old fashion way, drip count. Then run your pit through the pump and hook into the closest port. There is no need for another bag of fluid - that's just a waste. One bag on anesthesia tubing for mainline and emergencies/bolus and your pit bag through your pump.

BTW, if you are running a mainline through a pump at a certain rate (say 125ml/hr) then run a secondary line through the same pump at a different rate (say 50ml/hr) the pump will push 50ml/hr through until the VTBI from the secondary is gone. I don't think it will be smart enough to pull 50ml/hr from your secondary and 75ml/hr from your primary to give you a total infusion rate of 125ml/hr.

I wish they would invent one though - sure would make it easier when runnig pit/mag/mainline together and constantly titrating dosages but not to exceed 125ml/hr.:rolleyes:

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That is exactly how we used to do it....but now the hospital (and the state, like they know what they're talking about) insists that everything (even normal IV fluids) be run on a pump. They're not even happy about us having an anesthesia line, but anesthesia trumped that decision.

As for the two separate rates, you do have to tell the pump what you want the two separate rates to be at, so LR at 125, and then your PIT at whatever it's going to go at. Manufacturer still says that there will only be say 6cc/hr worth of pit released ito the line, even if the LR is at 125..........

How frustrating!:down:

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Here's what we do: We start the IV with whatever fluid is ordered with a primary line. When the pitocin is needed, it is also on a main line and piggy-backed to the closest port to the vein.

The pitocin must run on the machine. It can't be controlled otherwise.

The other main line of fluid can be put to tko by gravity or placed on a different pump at whatever rate.

If you hang the pit on a secondary line, you can't have the fluid and the pit running at the same time.

This is what we do too. With the pit at the closest port to the patient to minimize the dead space someone else mentioned. We have both fluids (or all three if abx) on the pump.

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This is what we do too. With the pit at the closest port to the patient to minimize the dead space someone else mentioned. We have both fluids (or all three if abx) on the pump.

We do the same thing. Makes the most sense.

steph

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