Amicillin via UAC?

[I'mANurse!]

A few weeks ago I was caring for a baby that had a UAC (no UVC), and a PIV in place. Babe was on amp & gent. During my shift, the PIV went bad, so I placed a new one. Awhile later, the charge nurse was roaming the unit to get updates on patients. I mentioned that I had just replaced the pts PIV. She asked me why this baby needs a PIV. I told her because he was receiving ampicillin and gentamicin and he was due for the amp. She then says, "Why didn't you just give the amp through the UAC?" I told her that I didn't know I could ( I thought we only used our UACs for blood gases & BPs). She just says "yeah you can" and walks off without any other explanation, leaving me feeling like an idiot/incompetent. I mentioned this to one of my more experienced co-workers (i've only been there 1 yr), and she told me that was an "old-school" thing. So, I was wondering, do you all give ampicillin in UAC's? Did I poke this baby and insert and IV for no reason? Do you give any meds via UACs? But I will say that my PIV came in very handy later in the shift when the pt crumped and went into pulmonary HTN....

[PICNICRN, BSN, RN]

It is kinda old school.... I can recall a time long ago when I used a UAC to infuse blood product because I had no other good option. Ideally, it should not be used to infuse. As for something like Amp/Gent- I would think you were absolutely right in starting another PIV. I would have.

[preemieRNkate, RN]

In a real crunch, with absolutely no other access, yes. Ideally, we give it a real good try to get a peripheral line in though. We give blood products through UACs more frequently than we give antibiotics through them. I think in the 5 years I've been doing this, I've used a UAC maybe twice for antibiotics.

[300g]

It's really going to depend on your unit policy and culture. Yes, you can give ampicilllin, gentamicin and a lot of other medications through UACs (and some should never be given via UAC like inotropes). However, I'm with you and the others here... I would have started another PIV. I prefer to avoid giving anything via UAC unless an extreme case or emergency.

[dawnebeth]

The only thing I have ever given through a UAC routinely (as opposed to a code or an emergency) is blood by aloquots. Otherwise, yeah, you did need a PIV.

Dawn

[dawngloves, BSN, RN]

I've only given blood and fluids during an emergent situation and I can count on one hand how often that was.

[BabyLady, BSN, RN]

It's really going to depend on your unit policy and culture. Yes, you can give ampicilllin, gentamicin and a lot of other medications through UACs (and some should never be given via UAC like inotropes). However, I'm with you and the others here... I would have started another PIV. I prefer to avoid giving anything via UAC unless an extreme case or emergency.

This is what we were told as well.

We were told that a UAC was "exit only" unless that baby was coding and you didn't have other access.

From my understanding, arterial access is more difficult to obtain than venous access...therefore, all measures need to be taken to protect the arterial line, especially if the baby is getting blood draws for frequent ABG's.

We have one baby in our unit that is two months old. He has all kinds of problems and his UAC was removed on day 20 to allow closure. They stuck that baby to death drying to get an arterial access and never could establish one.

I don't even want to tell you what this kid's feet look like from all the capillary draws.

[PrudenceNurse]

AmPicillin===I have been working NICU for 26 years in several different states, and I have never heard of a reason NOT to give meds through the UAC instead of sticking a baby for a PIV. Especially the Extremely Low Birthweight (ELB)babies. Our ELB policy is to NOT put a PIV in---just use the UAC/UVC. We do not run drips or anything continuous through this of couse, because we use it for drawing blood and we'd be giving a bolus. Also as someone else mentioned, no vasopressors should EVER be put through a UAC.

[ncbeachgrl]

Drugs such as ampicillin can cause the artery to spasm even if given slowly, but there definitely isn't any hard set rule that states you can't give abx through the UAC. I agree with others; it will depend on your unit policy (and there really should be one). I have worked in units where you gave meds via the UAC routinely, in other units where you only did it if you couldn't get peripheral access, and yet in another that you couldn't give meds through it unless you had a physician's order. Unfortunately it's like most things in the NICU; what is common practice in your unit? Hope this helps!

[babiesRmylife]

I'd check with your unit policy & procedures to be sure.

I know our unit we put NO medications though the UAC. The only thing we ever put through a UAC is TPN, Sodium Acetate, Sterile Water.

[Bortaz, MSN, RN]

I am appreciative of this thread, because I was just told yesterday, by my preceptor (I'm doing my end-of-nursing-school practicum), that the UAC is only used for blood draws, arterial bps, and occasionally a low level heparin infusion. It's comforting to know that our unit is running similar to others around the country.

[grinbyrd2]

We use a double lumen UAC and give fluids/TPN/meds via 1 port and use the other port for continuous blood pressure monitoring and lab collections. We also give blood through the UAC via the monitoring port in the VLBW infants. We don't start a PIV if they have a UAC in place unless they are a bigger baby needing a transfusion or have a med that is incompatible with the maintenance fluids or TPN. Once the patient is stable a PICC line is placed and the UAC is D/C'd. We have been very successful with this practice and it saves the patient a great deal of sticks.