Amphotericin B

[bellehill, RN]

I have been infusing a pt with 500cc of Ampho B. I set up the priamary line with D5W and the PB with the AmphoB. I have no problems priming the tubing but once I set the pump to infuse the Ampho the D5W drips instead. This has happened two nights in a row. The only way to stop it is to clamp the D5W with hemostats then the Ampho drips fine.

My question...is the Ampho B thicker than D5W therefore causing the "easier" of the two to flow (D5W)? Am I doing something wrong? Any solutions, I have stared at this tubing forever with no answer.

PS: I hooked it up as a PB since it is only compatible with D5W and wanted to make sure that is how it was flushed.

[mybuddycat]

The hosp I work at, we use double med pumps that we can set the drip rate. But, this is a ped hosp. It does work very well.

[jemb]

I use primary tubing for Ampho, and hook it to the primary D5W line via the port closest to the patient. That way the Ampho tubing goes through the pump. When the Ampho has infused, the pump alarm reminds me to switch over to the D5W tubing to flush the line.

[canoehead, BSN, RN]

Was the Ampho lots higher than the mainline? If you dilute with a larger bag the drip chamber ends up closer to the main line and may not drip.

[bellehill, RN]

Good idea too hook them both up on primary lines. I did have the D5W much lower than the ampho which was mixed in a glass evacuated container (for some reason). Thanks for the ideas!

[jemb]

Another thought now that you say the ampho was in a glass bottle...

Was the piggytback tubing vented or did you need to place an additional vented spike between the tubing and the bottle? Not having vented tubing could have kept it from infusing.

[bellehill, RN]

It was vented tubing.