Central line compatibility

[mfarmer88]

So yesterday, I an ER nurse brought a patient to ICU with just respiratory and me. Which is fine. When I get up to ICU the director is waiting for me, and yelling at me for having levophed and NS with bicarb going through two different ports of a central line and how they're not compatible. Then the rest of her nurses belittled me about "oh did someone forget that?" And they all laughed. Humiliating, sure. Frustrating? Very. Anyway, I came here to get some insight from some fellow nurses, aren't triple or double lumen lines like a CL or a PICC designed so that noncompatible medications can go through different ports without having to start new lines on patients? I did not have these Y-sited in. They were through different lumens/ports whatever you want to call them. Was I wrong?

[Been there,done that, ASN, RN]

Did the director actually "yell" at you? That would be problem # 1.

Not having even confidence in your skills to calmly explain the rationale of using multi-lumen central lines is problem # 2.

So what did you do with the drips?

[Creamsoda, ASN, RN]

if you know for sure that your drips were seperate....write an incident report for unprofessional behavior. They are out of line. They need to get their attitude in check.

[sjalv]

Did you clarify what you know to be the truth, i.e. that the lumens are separate and even if the medications are incompatible, they are fine to infuse through separate lumens?

[Ruby Vee, BSN]

Sounds vaguely Kafkaesque.

Answer 1a: Yes, central lines are designed so that non-compatible medications can be run through different lumens at the same time. Each lumen has its own discreet path through the catheter until exiting into a large blood vessel.

Answer 1b: The nurses in an ICU know this. We couldn't do our jobs without knowing this. Maybe if it was just one newbie berating you, we could chalk it up to a mistake on her part, but not a whole bunch of ICU nurses. So I'm wondering if something was lost in translation here. Are you certain you were administering the medications through different ports of a central line, and not just through something like a y-connector or stop-cock rig hooked up to a single port? I know I've seen nurses administer non-compatible medications through a y-connector hooked up to an EJ (peripheral) line, falsely believing that the y-connector made it two different ports.

Or could they be working under an antiquated policy and really not know the lines are designed to run incompatible drugs through different lumens?