Dc'ing nitro drip

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My question is really in relation to IV tubing, I suppose. The other day, I dc'd a nitro drip on my patient after titrating it down. I disconnected the tubing and flushed normal saline through the long IV pump tubing, so we could reuse the tubing (my hospital is on a waste-minimizing kick). But what do I do about the fluid that is still in the IVAD that is going into the patient? I didn't want to flush it quickly because of all the nitroglycerin sitting there.

Am I supposed to rehook him back up to NS on the pump and run it slowly at approximately the same rate he was getting nitro at? Or can I pull back on the IVAD and waste what is in it and then flush? Or is it ok to flush the IVAD semi-quickly and just monitor his BP?

Thanks for your input

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Please just toss the tubing. Do not put the pt at risk over saving the hospital money. Whatever you do, do not flush that nitro into the pt quikly, because you can bottem him out, resulting in a bad day for both of you. Besides, once the nitro has been d/c'd, giving him any more would consitute prescribing, and that is a no -no. Better safe than sorry, toss the tubing.

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Specializes in CTICU.

NTG actually sticks to PVC plastic of the tubing - which is why you're meant to use glass or non-PVC receptacles & tubing. I would NOT reuse IV tubing. That's not being cost-wise, that's being unsafe in my opinion, particularly with this drug.

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Specializes in CT ICU, OR, Orthopedic.

I've never heard of such a ridiculous thing!! Re use the tubing!? I guess maybe I'm not quite understanding...how do you keep the tubing sterile? Are you talking about "Y" connecting it to the Saline iv tubing? What are you flushing and saving? Or are you talking about leaving the dcd bottle up in case you need to restart it? Now we to that, as long as the bottle isn't expired...

Pt safety over money...sometimes we need to advocate to the "powers that be" what is safe, and what is not...

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Specializes in Med-Surg, ER.

I'd like to hear more about this tubing being recycled - I have a pt in my ED that is coming in daily for outpatient antibiotics via PICC. She was on vacation last month and told me that the hospital that she went to would wind up her tubing every day after her abx were infused so that they could re-use it. I thought surely she was wrong, that maybe they were saving the tubing for some other non-medical purpose, or that they had a special waste bin for it. She still insisted that she thinks she used the same tubing the whole week she was there. How can this in any way be considered good nursing practice? Am I missing a piece of the picture somewhere?

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Specializes in CT ICU, OR, Orthopedic.
I'd like to hear more about this tubing being recycled - I have a pt in my ED that is coming in daily for outpatient antibiotics via PICC. She was on vacation last month and told me that the hospital that she went to would wind up her tubing every day after her abx were infused so that they could re-use it. I thought surely she was wrong, that maybe they were saving the tubing for some other non-medical purpose, or that they had a special waste bin for it. She still insisted that she thinks she used the same tubing the whole week she was there. How can this in any way be considered good nursing practice? Am I missing a piece of the picture somewhere?

I am speechless!!

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Specializes in Infusion Nursing, Home Health Infusion.

In this case you need to just toss out the tubing.....PLEASE...if anyone tells you otherwise they are wrong as this violates what would be considered the standard of care in this situation.. never reuse tubing once it has been used for its primary purpose..Most hospitals will have a policy for tubing changes every 72-96 hrs as the INS and CDC vary a bit on this. Certain specaility drips such as lipids with TPN are usually 24 hrs and Propofol is usually just 12 hours. Primary intermittent should be 24 hours....so if a VAD is locked off and you are hanging Vancomycin q 12 hrs it would only be used twice. How you deal with the nitro being in the VAD really depends upon the priming volume in that line. Most Central lines have a lower priming volume than you would think and range from . 5 ml to 2.0 ml.....the most would be in a port or tunneled line such as a chest groshong or Hickman and Broviac. and those would not exceed about 3 ml......so unless the drug is really concentrated you can just flush it....if concentrated you will need to hang a compatable IVF at the same rate until line was clear of the drug

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