About IV piggyback

loriangel14, RN · Mar 16, 2012

Yes you have to set up a primary.I use NS.Set it up to start running and then add the second line.

Aerielle · Mar 16, 2012

When there is an order for IV medication and it does not specify, the nurse is able to choose to give it piggy back or IV push, depending on the patient's need/condition.

Like loriangel14 said, you do need a primary if you are giving it by piggy back. Be sure to check your Parenteral Drug Guide to use a primary solution that is compatible with your medication! :) The amount and rate of primary solution used would also depend on the patient too or if there is a special order - otherwise usually TKVO rate is used. (To keep vein open, 30mL/hr)

(I am a student in Canada...it may be different where you are!)

Sean-S · Mar 16, 2012

Thank you guys! I got it.

nurseprnRN, BSN, RN · Mar 16, 2012

sometimes docs write for "piggyback" when they just mean "minibag," particularly if they don't know or have forgotten that the patient does not have a running iv.

you can always plug a minibag directly into a locked iv, run it in over the specified time period, and then unplug and flush with whatever the facility policy specifies for locks, either plain ns or heparinized ns.

you would need a specific order to have a kvo (keep vein open) or tko (to keep open) primary hung and running.

grownuprosie · Mar 16, 2012

i am confused.

i just finished my first med/surg clinical and this has not been my experience. the docs will order a 50ml pb q6h and it was always run with primary tubing and then saline flushed and locked when not in use. no primary fluids necessary. is this not the norm? it was my understanding that "piggyback" was a throwback term. is it within the rn scope of practice to hang fluids when not ordered as was suggested earlier in the thread?

thanks for asking this question, sean-s!

loriangel14, RN · Mar 16, 2012

It may depend on where you are practicing.I am an RPN in Ontario and I don't need an order to hang a primary NS line but i will lock it after the med has finished.A med is pretty much always run as a secondary.

grownuprosie · Mar 16, 2012

I think you hit the nail on the head, loriangel14. It probably does depend on where you are practicing. Thanks for clearing that up!

Esme12, ASN, BSN, RN · Mar 16, 2012

It depends on the policy and standard of practice where you work. There will be some places that order a piggy back and without a specific order to hang fluid......the "piggyback" or "mini bag" can be infused directly into the hub without a hanging fluid. I would follow policy and I would ask for an order clarification if you are going to hang additional fluid. I would also be sure to hang a minimal amount of flush fluid to prevent an accidental fluid over load. :)

loriangel14, RN · Mar 16, 2012

Yes you have a good point.We hang a primary to flush and I usually use a mimimal amount.We usually don't have a specific order for a primary.

Sean-S · Mar 17, 2012

I am RPN student in Toronto. In the hospital I am practicing, I have to set up the primary line with NS 100mL in order to infuse the piggyback. I believe it depends on where you are. And I asked my clinical instructor who said the piggyback can't be given without primary line.