A few quick questions on IV piggyback and Saline lock

[Adriana25]

I was wondering what is the rationale to hooking the pt up to a saline lock before administering a drug by IV piggy back if they aren't already hooked up to one while they are hooked up to a primary IV). The lab nurse said it was in case you had to stop the IV quickly but wouldn't you be able to just unhook it and place one of those sterile blue hubs on the end if you needed to or clamp the line?

Also, I was told to count the drip rate of the primary colution right BEFORE setting up the administration of the IV piggyback to see if it matches what is ordered. What is the rationale? Does it have something to do with fluid overload risk?

[darren_callcareer18]

Saline lock is usually used for low risk client esp for those clients who doesn't need fluid replacement. As with your case, I think the medication must be administered in a slow manner or at the given specific time ( e.g antibiotic or heparin).

[shhhh]

I THINK I understand what you're asking, but let me know if I'm way off base here and unhelpful!

If you have a patient who's not getting continuous IVF, you should attach a saline lock to the IV cannula. That way, the patient won't be attached to the IV pole for hours on end (it's silly to force someone to be attached to an IV pump and pole if they're not even getting any IVF). Typically on a primary line, the port nearest to the IV isn't close enough to ensure that positive pressure flushing is effective (that clamp on the saline lock tubing is very important part of that). A saline lock will allow you to flush the IV with enough force to ensure adequate positive pressure flushing.

It's not a great idea to detach the primary tubing from the IV itself any more times than you have to because 1) if the IV is in a great vein, you'll end up spurting tons of blood and making an unnecessary mess, 2) there's usually tape securing the IV AND whatever IV tubing is attached to it and retaping that over and over again would be a pain and serious waste of time, 3) you might accidentally pull out the IV if you're not careful when you detach the tubing and 4) a sterile cap might not even be compatible with the hub of the IV cannula.

You might be referring to a flush valve instead of a sterile hub, though. I would advise against attaching a flush valve directly to the IV cannula just because I feel that the little extra saline-lock line provides enough slack to attach the IV securely to the patient and prevent an accidental pull out, and you'll be able to see any blood return when you aspirate while you flush. Also, just the little knub of the flush sticking out of the skin is tough to handle if you're flushing, and sometimes patients don't even notice those and aren't careful and accidently pull them out.

As for the IV drip rate, what you're probably talking about is what nurses would do if they're infusing fluids without an IV pump. If that's the case, you're right; you should check the drip rate often to prevent accidental fluid overload. But if you're working in most facilities, you can most likely count on your IV pump dripping everything through at the right rate and you should just focus on programming your pump at the right rate.

Hope I helped out! Let me know if I didn't! :)