Any good rules of thumb r/t IV compatibility? & your preferences?

[IheartICUnursing]

So at work we have a very good online reference where it is very easy to type in several meds and see whether or not they are Y- site compatible. I've been meaning to play around with it and get an idea of compatibilities for drugs that we use most commonly, but there's just never that kind of leisure time in an ICU lol

I guess over time you start to memorize some combinations that you have come across the most but I have only been working for two months so I'm not quite there yet :) Just wondering if any of you guys have come across and good rules of thumb or common drug combos that are compatible.... for example, I know that the pressors are all compatible with eachother.

My concern is that when a patient is crashing, already has multiple drips going, I need to start a few more and only have, say, one triple lumen central line and dont have time to play around with an IV compatibility chart.

On a related note, when time permits and you have time to play around and rearrange lines, do you have any preferences as to what you run with what? Personally, I like to try and keep like medications together if possible/ compatible, like all my pressors going into one line, pain med/ sedation/ paralytics in one, etc. Just for organization sake and making it easier to remember what is running with what.

Thanks :)

[resumecpr]

That's part of the fun and excitement of being an ICU nurse! When you have that crashing patient, and need to reference IV compatability, the pressure is really on! I love that feeling!!

I don't think there is an easier or faster way to do it though. Sounds like you're pretty competent with what you described.

[detroitdano]

If I ever have that many drips running at once, I ALWAYS print a compatibility chart for all drips, abx, and IVP meds the patient is on. Comes in handy. You'll come to figure out real easy ones like Fentanyl and Versed and okay together, blood and D5 is not, but there's a slew of abx out there that can't be run with maintenance fluids like LR. Trying to remember all that is far too much work, just make a chart.

[elk280]

1. Make sure you always have one port for iv fluids/meds to.piggy back or push. Example:antibiotics, code cart meds to push. All antibiotics ...well most...are compatible with one another and with potassium and mag.

2. One port can be for your pressors. They are all compatible with one another.

3. Your third port can be whatever else...boluses, blood, etc.

Always label your iv fluid/med line at the y site so you can quickly locate it to push drugs and dont by accident push drugs through your pressors line...i always label every y site...makes things easier and more safe. As well as the pump. Always have someone double check.your pump settings.

[MaroonTX]

I am new nurse in the ICU also (~3 months) and what many of us have started to do (since there's quite a few newer/inexperienced nurses on our unit at the moment), is print off a list of Y-site info for our pt's and pass them off during shift change. These lists usually include what drips/meds the pt. is currently on + common emergency/procedural drugs we use. When there's a change made people will update the lists, or if time did not permit during that particular shift they will just mention that there was a change and I will usually try and update the print out at start of shift. It really helps save time (not to mention paper) to hand these off rather than printing out new ones every shift. We don't expect the experienced folks to update them of course, but they have been great about keeping them to pass along and will just mention during report that these meds have been started so you may want to add them to the list. Another thing I started to do is make a master list of all the IV drugs I've encountered (starts off a little tedious, but eventually you won't have to add drugs that often) and just play around with them on the Y-site program on your days off. Definitely not close to being an expert yet, but the repetition is helping things to start and sink in. If I've learned anything in these past couple of months its that being a new nurse is like being in school. Your job is definitely not over when your shift ends, you gotta study and do your homework on your days off, b/c as you mentioned free time is a rare occurrence during your shift (esp. us newbies, who are much slower at getting things done lol)

[Biffbradford]

Prob. easier to remember which one's are not compatible with others. I think that list is shorter. Lasix for example.

[picurn1972, RN]

dont forget Protonix!!

[hodgieRN]

If I ever have that many drips running at once, I ALWAYS print a compatibility chart for all drips, abx, and IVP meds the patient is on. Comes in handy. You'll come to figure out real easy ones like Fentanyl and Versed and okay together, blood and D5 is not, but there's a slew of abx out there that can't be run with maintenance fluids like LR. Trying to remember all that is far too much work, just make a chart.

Agreed. It's always good to print one out. Don't forget to ask pharmacy. Another big one is LR...some drugs don't mix with it (I think Zosyn is one). Diprivan and TPN are compatible.