A question??

jadelpn, LPN, EMT-B · Jul 10, 2015

There should be a facility policy on this, so see what yours is.

As a general rule in our facility, if the person is NOT on IV fluid continuous (and be really mindful to be sure the abx is compatible with the fluid running if they are on continuous) we have to hang a 50cc bag of fluid, piggyback in the abx.

If it is the same abx. the tubing can only be used q 24 hours. If it is different, then it has to be entirely different secondary tubing. Each policy is different, and some are different depending on what kind of access you have.

We also have to date and time the tubing.

Salisburysteak, BSN, RN · Jul 10, 2015

Ours(abx) is mixed in NS and it is piggybacked with 100ml bag of NS.

I have seen nurses use the same secondaty for multiple abx like vanco then hang merrem with the same tubing. I never felt comfortable doing that. Our policy is all tubing is changed q 72 hrs date and timed.

Thank you for the info!

Surprised1, MSN, RN · Jul 10, 2015

Ours(abx) is mixed in NS and it is piggybacked with 100ml bag of NS.
I have seen nurses use the same secondaty for multiple abx like vanco then hang merrem with the same tubing. I never felt comfortable doing that. Our policy is all tubing is changed q 72 hrs date and timed.
Thank you for the info!

We use different tubing for each different ABX. So, merepenem gets its own tube, vanc gets a tube, etc.

flipflopsNsweetTea · Jul 10, 2015

We don't have to piggyback with NS, and we use different tubing for each abx. The tubing for secondary lines is good for 24 hours per our policy, but I generally hang new secondary tubing with each new bag.

Salisburysteak, BSN, RN · Jul 10, 2015

We use different tubing for each different ABX. So, merepenem gets its own tube, vanc gets a tube, etc.

Just as it should. I was just making sure I have been doing it correctly. I have seen other nurses use the same tubing for different abx's.

Thanks for the replies!!

IVRUS, BSN, RN · Jul 10, 2015

Well, your first concern needs to be compatibility. If drug X is compatible with drug Y, and all you're doing is hanging another IVAB then use the same tubing, but if they aren't compatible, or if you are in doubt, use seperate tubing.

But as another post stated, follow your institutions policy.

Also, if you are running the IVAB as a secondary infusion because you have a mainline, then as long as they are compatible, back prime and hang the next IVAB. If everyone is backpriming, then the tubing can be changed q 96, instead of q 24 in most institutions.

CT Pixie, BSN, RN · Jul 10, 2015

We use seperate tubing for each IVPB med.

weirdscience · Jul 14, 2015

I was taught to back prime and use same tubing. Rationale was that constant breaks in system (e.g. frequently disconnecting/reconnecting luer-lock at the b-line port) were an infection risk. This was the practice in nursing school as well as on the oncology floor, where many of our pts were immuno-compromised. However, in critical care, I see nurses using separate PB tubing, even if abx/lytes are compatible. We don't have a written policy on this, but I wish we did.

Our tubing change policy is q96hr across the board, unless it's TPN or propofol or something.

Oh'Ello, BSN, RN · Jul 14, 2015

Uhh... what weird science said. You just back prime if its not compatible and spike the next med. Using separate tubing for each med just creates a nightmare of an IV pole, more risk for infection, and another nightmare when figuring out when tubing has to be changed, amirite?

Not only that it just seems kinda wasteful.

In the example you used...Vanco and meropenem. The 2 drugs are compatible. What is the source of your discomfort?

~PedsRN~, BSN, RN · Jul 15, 2015

I don't see how using the same tubing *decreases* your infection risk, when you are repeatedly spiking new bags of abx. Disconnecting the tubing at the secondary or at the spike - both are opening the line?

Our facility piggy backs antibiotics for the most part, and yes - I definitely have a line per antibiotic. I label them, curos cap the ends when not in use.

MunoRN, RN · Jul 15, 2015

I don't see how using the same tubing *decreases* your infection risk, when you are repeatedly spiking new bags of abx. Disconnecting the tubing at the secondary or at the spike - both are opening the line?
Our facility piggy backs antibiotics for the most part, and yes - I definitely have a line per antibiotic. I label them, curos cap the ends when not in use.

To use a different secondary tubing for each antibiotic requires you to manipulate the secondary to primary connection repeatedly, that manipulation can introduce bacteria unnecessarily.